Jeevaka Yapa DDS PC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

16026 Issued in MI

Legal business name

JEEVAKA YAPA DDS PC

Practice address

30555 Greenfield Rd
Southfield, MI 48076-1594

Phone

(248) 262-9100

Fax

(248) 262-9104

NPI assigned

Mar 26, 2008

Organization subpart

No

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

Authorized official

Name

Kanesha Canty

Title

Office Manager

Phone

(248) 262-9100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• NEW CENTER ORAL & MAXILLOFACIAL SURGERY Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeevaka Yapa, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Southfield, MI
  • NPI 1013957281
  Medicare reassignment

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757030400000",
    "number": "1457523755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30555 GREENFIELD RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480761594",
            "telephone_number": "248-262-9100",
            "fax_number": "248-262-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30555 GREENFIELD RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480761594",
            "telephone_number": "248-262-9100",
            "fax_number": "248-262-9104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEEVAKA YAPA DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A",
        "authorized_official_last_name": "CANTY",
        "authorized_official_first_name": "KANESHA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "248-262-9100"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "16026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12 3259450",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEW CENTER ORAL & MAXILLOFACIAL SURGERY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phoebee Jean
• Jeanette'S Home LLC
• Julian Jeberaeel
• Jeci Medical Supply Inc.
• Beata Jedrzejczyk, LLMSW
• Tomyia M Jefferson
• Jeffrey M Last PHD PLLC
• Jeffrey T Najor MD PLLC
• Tamika Jeffries
• Sudhakaran Jegadeesh, PT, MBA

• Oral and Maxillofacial Surgery Clinic/Center in Southfield, MI
• Providers in Southfield, MI by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.