Healthcare Provider Details

I. General information

NPI: 1992609044
Provider Name (Legal Business Name): YOMAIRA ROSAS RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

647 COUNTRY CLUB TER
LAWRENCE KS
66049-2450
US

IV. Provider business mailing address

2513 E 25TH PL
LAWRENCE KS
66046-5361
US

V. Phone/Fax

Practice location:
  • Phone: 785-648-1060
  • Fax:
Mailing address:
  • Phone: 620-757-2759
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number12166
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: