Provider Demographics
NPI:1912111261
Name:YAMANAKA, RYAN AKIRA (DDS)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:AKIRA
Last Name:YAMANAKA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1378 CONCANNON BLVD
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-6004
Mailing Address - Country:US
Mailing Address - Phone:925-443-8822
Mailing Address - Fax:925-443-6335
Practice Address - Street 1:1378 CONCANNON BLVD
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-6004
Practice Address - Country:US
Practice Address - Phone:925-443-8822
Practice Address - Fax:925-443-6335
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA478291223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics