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1922165059 NPI number — MERVYN YANKELSON BDS.,MSC

NPI Number: 1922165059
Health Care Provider/Practitioner: MERVYN YANKELSON BDS.,MSC

Information about “1922165059” NPI (MERVYN YANKELSON BDS.,MSC) exists in 1922165059 in HTML format HTML  |  1922165059 in plain Text format TXT  |  1922165059 in PDF (Portable Document Format) PDF  |  1922165059 in an XML format XML  formats.

NPI Number : 1922165059 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1922165059",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "YANKELSON",
    "FirstName": "MERVYN",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "BDS.,MSC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6310 MAURY HOLW",
    "SecondLineMailingAddress": "136",
    "MailingAddressCityName": "AUSTIN",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78750-8257",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "512-346-9621",
    "MailingAddressFaxNumber": "512-346-7206",
    "FirstLinePracticeLocationAddress": "6800 W GATE BLVD",
    "SecondLinePracticeLocationAddress": "SUITE 136",
    "PracticeLocationAddressCityName": "AUSTIN",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78745-4883",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "512-442-3480",
    "PracticeLocationAddressFaxNumber": "512-442-7274",
    "EnumerationDate": "01/01/2007",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1223P0700X",
        "TaxonomyName": "Prosthodontics",
        "LicenseNumber": "12924",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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