Kevin C Yoder, DDS
Individual provider Active NPI General Practice Dentistry · Berlin, OH
NPI 1184731986 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1184731986
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 30016814 (OH)
- Practice address
- 4913 West Main St.
Berlin, OH 44610 - Phone
- (330) 893-3141
- Fax
- (330) 893-3513
- NPI assigned
- Aug 25, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30016814 | OH | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 30016814 | OH | Yes |
Addresses
Primary practice location
4913 West Main St.
Berlin, OH 44610
Mailing address
4913 West Main St.
Berlin, OH 44610
Phone (330) 893-3141
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1223G0001X | Other | OH | TAXONOMY CODE |
| 30016814 | Other | OH | STATE LICENSE NUMBER |
Other providers in Berlin, OH
All providers in Berlin, OH · General Practice Dentistry in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.