Individual provider Active NPI

Douglas Corbin Yauch, D.D.S.

  • Dentist
  • Saint Louis, MI
National Provider Identifier
1366638280
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901018316 Issued in MI
Practice address
8585 N Croswell Rd
Saint Louis, MI 48880-9210
Phone
(989) 681-6444
NPI assigned
Sep 25, 2007
Last updated
Sep 25, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901018316 MI Primary

Addresses

Primary practice location

8585 N Croswell Rd
Saint Louis, MI 48880-9210

Mailing address

4642 Clareola Ave
Lake, MI 48632
Phone (989) 544-2824

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
2901018316MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1366638280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4642 CLAREOLA AVE",
            "city": "LAKE",
            "state": "MI",
            "postal_code": "48632",
            "telephone_number": "989-544-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8585 N CROSWELL RD",
            "city": "SAINT LOUIS",
            "state": "MI",
            "postal_code": "488809210",
            "telephone_number": "989-681-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAUCH",
        "first_name": "DOUGLAS",
        "middle_name": "CORBIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-25",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901018316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; 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.