Yoeli Park, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

YOELI PARK, PLLC

Practice address

10572 W Business Park LN
Boise, ID 83709-6797

Phone

(208) 375-5656

NPI assigned

Aug 15, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Jason Hammer, DMDNPI 1053441451

Title

Owner/Docter

Phone

(208) 466-8400

Specialties & licenses 1

Addresses

Other names 1

• Stevens Dental Doing business as

Practitioners 3

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

• Jason B Hammer, DMD

  • General Practice Dentistry
  • Nampa, ID
  • NPI 1053441451
  NPD (past) Authorized official
• Robert Orlo Stevens, D.M.D., P.A.

  • Dentist
  • Boise, ID
  • NPI 1659717916
  NPD (past)
• Joshua James Heyrend, D.M.D.

  • Dentist
  • Tempe, AZ
  • NPI 1174062095
  NPD (past)

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534291200000",
    "number": "1730669292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 7TH AVE S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836513846",
            "telephone_number": "208-466-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10572 W BUSINESS PARK LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837096797",
            "telephone_number": "208-375-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOELI PARK, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-15",
        "last_updated": "2018-08-15",
        "status": "A",
        "authorized_official_last_name": "HAMMER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER/DOCTER",
        "authorized_official_telephone_number": "208-466-8400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stevens Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Stevens Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ishael Kayra Yildiz, BS
• Alfred Cesar Ynda
• Lauren Yoder-Goeden
• Brenda K Yoder, RPT
• Sarah L. Yoder, B.S.,COTA
• Nicholas J Yokan, M.D.
• Marc Alan Yonkers, M.D./PH.D.
• Eric Taeho Yoon, PT, DPT, CSCS
• Kyle R. Yorgason, D.P.M.
• Ruth Cortner York, MPH, CPC

• Dental Clinic/Center in Boise, ID
• Providers in Boise, ID by specialty
• Dental Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.