Tony Yassa

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN28213 Issued in FL

Practice address

611 S Dixie Fwy
New Smyrna Beach, FL 32168-7355

Phone

(386) 259-3790

NPI assigned

Jun 21, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1687305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1194400622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1931 MENDOCINO LN",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321287408",
            "telephone_number": "386-290-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 S DIXIE FWY",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687355",
            "telephone_number": "386-259-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YASSA",
        "first_name": "TONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-21",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN28213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Robert Wise, DO
• Denise Wisely, DO
• Denise Wofford, M.S. CCC-SLP
• Joanne Georgiana Woods, RN
• Katelyn Lee Woods, DC
• Jeff Andrew Baldo Yepez, APRN
• Yogesh H Shah MD PA
• Crystal Nicole Young, APRN
• Robert C Youngman, MD
• Yourchiro NSB

• General Practice Dentistry in New Smyrna Beach, FL
• Providers in New Smyrna Beach, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.