Individual provider Active NPI

David James Yoder, DDS

  • Dentist
  • Ponte Vedra Beach, FL
National Provider Identifier
1215257381
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN19044 Issued in FL
Practice address
3791 Palm Valley Rd
Suite 205
Ponte Vedra Beach, FL 32082-4182
Phone
(904) 673-5869
NPI assigned
Jun 10, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN19044 FL Primary

Addresses

Primary practice location

3791 Palm Valley Rd
Suite 205
Ponte Vedra Beach, FL 32082-4182

Mailing address

81 Roscoe Blvd N
Ponte Vedra Beach, FL 32082-3625
Phone (904) 673-5869

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

State licenses

LicenseStateTypeSpecialty
DN19044FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Valley Family Dentistry, PLLC CurrentSince Nov 24, 2024 Accepting new patients
Palm Valley Family Dentistry, P.a. Past Accepting new patients

Locations

3791 Palm Valley Rd
Ste 205
Ponte Vedra Beach, FL 32082
Phone (904) 673-5869

Organizations & group practices 2

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": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1215257381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 ROSCOE BLVD N",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320823625",
            "telephone_number": "904-673-5869",
            "fax_number": "904-267-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3791 PALM VALLEY RD",
            "address_2": "SUITE 205",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320824182",
            "telephone_number": "904-673-5869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YODER",
        "first_name": "DAVID",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-10",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.