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General NPI Number Information
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NPI Number | 1255772802
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Entity Type | Organization
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Legal Business Name | YAKEIKA L VANN DDS PLLC
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Dates
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Enumeration Date | 07/11/2013
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Last Update Date | 06/01/2023
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Provider Practice Location Address
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Address Line | 5716 WYALONG DR STE C
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City | CHARLOTTE
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State | NC
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Zip | 28227-7847
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Country | US
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Telephone | 980-819-8040
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Fax | 980-819-8043
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Provider Business Mailing Address
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Address Line | 5716 WYALONG DR STE C
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City | CHARLOTTE
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State | NC
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Zip | 28227-7847
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Country | US
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Telephone | 980-819-8040
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Fax | 980-819-8043
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Authorized Official
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Title or Position | CEO
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Name | YAKEIKA L VANN
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Credential | DDS
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Telephone | 980-819-8040
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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 | 8491
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License Number State | NC
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