Healthcare Provider Details

I. General information

NPI: 1992337497
Provider Name (Legal Business Name): RACHEL YAGHAR DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2020
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 UNION TPKE STE 208
NEW HYDE PARK NY
11040-1759
US

IV. Provider business mailing address

75 COLGATE RD
GREAT NECK NY
11023-1501
US

V. Phone/Fax

Practice location:
  • Phone: 646-807-6465
  • Fax:
Mailing address:
  • Phone: 646-807-6465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number062054-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: