Individual provider Active NPI

Simon B. Yanez, DDS

  • General Practice Dentistry
  • Hanford, CA
National Provider Identifier
1417094202
Registry record updated Oct 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
33173 Issued in CA
Practice address
210 Keith St
Hanford, CA 93230-2910
Phone
(559) 584-1588
Fax
(559) 584-1817
NPI assigned
Jan 31, 2007
Last updated
Oct 21, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 33173 CA Primary

Addresses

Primary practice location

210 Keith St
Hanford, CA 93230-2910

Mailing address

210 Keith St.
Hanford, CA 93230
Phone (559) 584-1588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231218001349 CA Practitioner - Dentist 4688825581 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Sierra Vista CurrentSince Nov 1, 2023 Accepting new patients
Clinica Sierra Vista CurrentSince Nov 1, 2023 Accepting new patients
Clinica Sierra Vista Current Accepting new patients

Locations

1305 Bear Mountain Blvd
Arvin, CA 93203
Phone (661) 854-3131

625 34th St
Ste 100200
Bakersfield, CA 93301
Phone (833) 578-2781

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256083200000",
    "number": "1417094202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 KEITH ST.",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "93230",
            "telephone_number": "559-584-1588",
            "fax_number": "559-584-1817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 KEITH ST",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932302910",
            "telephone_number": "559-584-1588",
            "fax_number": "559-584-1817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANEZ",
        "first_name": "SIMON",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2009-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "33173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanford, CA

Sources for this page

Verify at the official NPI Registry.