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General NPI Number Information
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NPI Number | 1215328356
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Entity Type | Individual
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Provider Name | YIMAR ANGELL DMD
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Gender | Female
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Dates
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Enumeration Date | 02/11/2015
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Last Update Date | 06/20/2022
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Provider Practice Location Address
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Address Line | 9126 TOWN CENTER PKWY STE 101
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34202-5052
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Country | US
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Telephone | 941-236-5695
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Fax |
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Provider Business Mailing Address
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Address Line | 6142 TURNBURY PARK DR APT 5206
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City | SARASOTA
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State | FL
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Zip | 34243-6137
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Country | US
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Telephone | 857-400-6888
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN1858216
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN1858216
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN1858216
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN23958
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License Number State | FL
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