Individual provider Active NPI

Andrea Lynn Oswald Yentz, DDS

  • General Practice Dentistry
  • Monroe, MI
National Provider Identifier
1558529149
Registry record updated Jan 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901019934 Issued in MI
Practice address
1080 N Monroe St
Monroe, MI 48162-3193
Phone
(734) 242-8885
Fax
(734) 242-1410
NPI assigned
May 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30022833 OH
General Practice Dentistry 1223G0001X 2901019934 MI Primary

Addresses

Primary practice location

1080 N Monroe St
Monroe, MI 48162-3193

Mailing address

1080 N Monroe St
Monroe, MI 48162-3193
Phone (734) 242-8885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160222001558 MI Order and Referring Only - DentistPractitioner - Dentist 8921303447

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901019934MIMDGeneral Practice Dentistry
30022833OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
David F. Yentz, D.D.S., P.C. General Practice Past Accepting new patients

Organizations & group practices 1

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": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264032000000",
    "number": "1558529149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 N MONROE ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481623193",
            "telephone_number": "734-242-8885",
            "fax_number": "734-242-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 N MONROE ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481623193",
            "telephone_number": "734-242-8885",
            "fax_number": "734-242-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YENTZ",
        "first_name": "ANDREA",
        "middle_name": "LYNN OSWALD",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-30",
        "last_updated": "2010-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30022833",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901019934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

Verify at the official NPI Registry.