Provider Demographics
NPI:1174549356
Name:AMANO, YOUNG YOSH (DDS)
Entity type:Individual
Prefix:DR
First Name:YOUNG
Middle Name:YOSH
Last Name:AMANO
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 1:1305 N SAN FERNANDO BL
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-4236
Mailing Address - Country:US
Mailing Address - Phone:818-842-4823
Mailing Address - Fax:818-842-4963
Practice Address - Street 1:1305 N SAN FERNANDO BL
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-4236
Practice Address - Country:US
Practice Address - Phone:818-842-4823
Practice Address - Fax:818-842-4963
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA277201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice