=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992609044
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YOMAIRA ROSAS RDH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/05/2026
-----------------------------------------------------
Last Update Date | 10/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 647 COUNTRY CLUB TER
-----------------------------------------------------
City | LAWRENCE
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66049-2450
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-648-1060
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2513 E 25TH PL
-----------------------------------------------------
City | LAWRENCE
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66046-5361
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 620-757-2759
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 124Q00000X
-----------------------------------------------------
Taxonomy Name | Dental Hygienist
-----------------------------------------------------
License Number | 12166
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------