Individual provider Active NPI

Yakeika Lynette Vann, DDS

  • General Practice Dentistry
  • Charlotte, NC
National Provider Identifier
1720105661
Registry record updated May 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3400-06 Issued in MS
Practice address
5716 Wyalong Dr
Ste. C
Charlotte, NC 28227-7847
Phone
(601) 630-5188
NPI assigned
Mar 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2011

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 3400-06 MS Primary

Addresses

Primary practice location

5716 Wyalong Dr
Ste. C
Charlotte, NC 28227-7847

Mailing address

5716 Wyalong Dr
Ste. C
Charlotte, NC 28227-7847
Phone (601) 630-5188

Other identifiers 2

IdentifierTypeStateIssuer
02629792MedicaidMS
5908012MedicaidNC

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
3400-06MSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Yakeika L Vann DDS PLLC Current Accepting new patients

Locations

5716 Wyalong Dr
Ste C
Charlotte, NC 28227
Phone (601) 630-5188

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": "1174694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306195200000",
    "number": "1720105661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5716 WYALONG DR",
            "address_2": "STE. C",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282277847",
            "telephone_number": "601-630-5188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5716 WYALONG DR",
            "address_2": "STE. C",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282277847",
            "telephone_number": "601-630-5188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANN",
        "first_name": "YAKEIKA",
        "middle_name": "LYNETTE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-24",
        "last_updated": "2011-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3400-06",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02629792",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908012",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2011; 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.