Emmanuel Yadoglah, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

34229 Issued in TX

Practice address

2260 Linda Ave Ste 103
Odessa, TX 79763-2665

Phone

(432) 333-4867

NPI assigned

Jun 11, 2018

Last updated

Jun 29, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bliss Dental PLLC

  dba Bliss Dental and Orthodontics

  • Dentist
  • Odessa, TX
  • NPI 1366737173
  NPD
• Familia Dental Big Spring PLLC

  • Dental Clinic/Center
  • Big Spring, TX
  • NPI 1003160664

  General Practice

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1083107494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2260 LINDA AVE STE 103",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797632665",
            "telephone_number": "432-333-4867",
            "fax_number": "432-333-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 LINDA AVE STE 103",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797632665",
            "telephone_number": "432-333-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YADOGLAH",
        "first_name": "EMMANUEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-11",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "34229",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34229",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie Wright
• Wthac, Inc (Miracle-Ear Center)
• WTX Harmony Evaluators
• Hao Ming Wu, M.D.
• Sanchita Yadalla, MD, FACOG
• Ranganayaki Yalavarthi, M.D.
• Kazuhiko Yanagi, ATC, LAT
• Zhibo Yang, M.D., PH.D.
• Abdallah Yassine
• Yulian Yiavlion Yestin, MD

• Dentist in Odessa, TX
• Providers in Odessa, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.