Paul Yaeger, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14395 Issued in MN

Practice address

3570 River Rapids Dr NW
Coon Rapids, MN 55448-4100

Phone

(651) 523-1093

NPI assigned

Jul 1, 2020

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)

Enrolled

State licenses

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1245857655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3570 RIVER RAPIDS DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554484100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3570 RIVER RAPIDS DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554484100",
            "telephone_number": "651-523-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAEGER",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-01",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Mai Der Xiong, PHARMD
• Keng Xiong
• Ruxuan Xiong
• Hany Nassif Yacoub, MD
• Daleso Yadetta, PA
• Yahweh Transport Services
• Kristen Yang, 5/2009
• Malika Yang
• Pang Yang
• Matthew Joseph Yauch, D.O..

• General Practice Dentistry in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; 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.