Yassmen Jaafar Etayem, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.033906 Issued in IL

Practice address

15614 S Harlem Ave Ste a
Orland Park, IL 60462-4401

Phone

(708) 614-1111

NPI assigned

Aug 8, 2022

Last updated

Aug 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Crystal Cove Family Dental PLLC

  dba Crystal Cove Family Dental

  • General Practice Dentistry
  • Orland Park, IL
  • NPI 1972392751
  NPD
• Otto J. Tor, D.D.S., LTD.

  • General Practice Dentistry
  • Orland Park, IL
  • NPI 1962717314
  NPD (past)

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1821726951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7623 SUSSEX CREEK DR APT 205",
            "city": "DARIEN",
            "state": "IL",
            "postal_code": "605614844",
            "telephone_number": "708-739-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15614 S HARLEM AVE STE A",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624401",
            "telephone_number": "708-614-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETAYEM",
        "first_name": "YASSMEN",
        "middle_name": "JAAFAR",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.033906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Utz Rd, LLC
• Amani Erra
• Henry Kevin Errek, PH.D.
• Kathleen Escalona, APRN, CNP
• Essence Healthcare Services LLC
• Linda C Evans Beckman, MD
• Meggan M Evans Forbes, APN-BC
• Eventide Wellness Inc
• Erin A Everett, DPT
• Evolve Pediatrics, LLC

• General Practice Dentistry in Orland Park, IL
• Providers in Orland Park, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.