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General NPI Number Information
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NPI Number | 1255622635
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Entity Type | Individual
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Provider Name | JOHN RUSSELL YANCEY DDS
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Gender | Male
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Dates
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Enumeration Date | 04/20/2011
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 8683 E LINCOLN AVE STE 130
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City | LONE TREE
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State | CO
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Zip | 80124-9812
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Country | US
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Telephone | 317-459-0738
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Fax |
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Provider Business Mailing Address
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Address Line | 12548 N 4TH ST
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City | PARKER
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State | CO
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Zip | 80134-9458
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Country | US
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Telephone | 317-459-0738
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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 | 8020326-9924
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | DEN.00203857
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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