Individual provider Active NPI

Jason Yole, DMD

  • General Practice Dentistry
  • Lake Havasu City, AZ
National Provider Identifier
1174839328
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8052 Issued in AZ
Practice address
2167 Birch Square Ste D
Lake Havasu City, AZ 86403
Phone
(928) 855-5159
NPI assigned
Aug 25, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8052 AZ Primary

Addresses

Primary practice location

2167 Birch Square Ste D
Lake Havasu City, AZ 86403

Mailing address

2167 Birch Square Ste D
Lake Havasu City, AZ 86403
Phone (928) 855-5159

Other practice location 1

2178 McCulloch Blvd N
ste 14
Lake Havasu City, AZ 86403-6864
Phone (928) 855-5059

Other practice location 2

2178 McCulloch Blvd N
ste 14
Lake Havasu City, AZ 86403-6864
Phone (928) 855-5059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pleasant Valley Dental Care, P.C. Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1174839328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2167 BIRCH SQUARE STE D",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "86403",
            "telephone_number": "928-855-5159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2167 BIRCH SQUARE STE D",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "86403",
            "telephone_number": "928-855-5159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2178 McCulloch Blvd N",
            "address_2": "ste 14",
            "address_purpose": "LOCATION",
            "city": "Lake Havasu City",
            "state": "AZ",
            "postal_code": "864036864",
            "country_code": "US",
            "telephone_number": "928-855-5059",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2178 McCulloch Blvd N",
            "address_2": "ste 14",
            "address_purpose": "LOCATION",
            "city": "Lake Havasu City",
            "state": "AZ",
            "postal_code": "864036864",
            "country_code": "US",
            "telephone_number": "928-855-5059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOLE",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-25",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "8052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.