Individual provider Active NPI

Yvonne Eleanor Deloache, D.D.S.

  • General Practice Dentistry
  • West Chester, PA
National Provider Identifier
1780807578
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
00204680 Issued in CO
Practice address
301 S High St
West Chester, PA 19382-3336
Phone
(610) 696-9135
Fax
(610) 692-7325
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2022

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 DS022216L PA
General Practice Dentistry 1223G0001X 00204680 CO Primary

Addresses

Primary practice location

301 S High St
West Chester, PA 19382-3336

Mailing address

777 Bannock St
Denver, CO 80204-4597
Phone (303) 602-3192

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20220519000522 CO Practitioner - Dentist 9739492646 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00204680COMDGeneral Practice Dentistry
DS022216LPAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince May 31, 2022 Accepting new patients
Denver Health and Hospital Authority CurrentSince May 31, 2022 Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

Interoperability endpoints

  • Direct secure messaging: ydeloache265076@direct.dhha.org

Organizations & group practices 2

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1780807578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-602-3192",
            "fax_number": "303-602-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S HIGH ST",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193823336",
            "telephone_number": "610-696-9135",
            "fax_number": "610-692-7325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELOACHE",
        "first_name": "YVONNE",
        "middle_name": "ELEANOR",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS022216L",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "00204680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, PA

Sources for this page

Verify at the official NPI Registry.