Healthcare Provider Details

I. General information

NPI: 1831329325
Provider Name (Legal Business Name): YANA KUSHNER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2009
Last Update Date: 07/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 N US HIGHWAY 183 STE. 150
LEANDER TX
78641-8990
US

IV. Provider business mailing address

651 N US HIGHWAY 183 STE. 150
LEANDER TX
78641-8990
US

V. Phone/Fax

Practice location:
  • Phone: 512-260-0123
  • Fax: 512-260-0110
Mailing address:
  • Phone: 512-260-0123
  • Fax: 512-260-0110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number24748
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: