Active NPI
George Michael Yellich, DDS MS
- Oral and Maxillofacial Surgery (Dentist)
- Santa Cruz, CA
National Provider Identifier
1841304276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 23580
- Practice address
- 1663 Dominican Way
Suite 112
Santa Cruz, CA 95065 - Phone
- (831) 475-0221
- Fax
- (831) 475-3573
- NPI assigned
- Aug 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 23580 | CA | Primary |
Addresses
Primary practice location
1663 Dominican Way
Suite 112
Santa Cruz, CA 95065
Mailing address
1663 Dominican Way
Suite 112
Santa Cruz, CA 95065
Phone (831) 475-0221
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23580 | Other | CA | DENTAL LICENSE |
| 256 | Other | CA | ANESTHESIA LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Feb 10, 2016 through Feb 10, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23580 | CA | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. George M Yellich DDS Ms Inc | Oral and Maxillofacial Surgery | Current | Accepting new patients |
| George M. Yellich, DDS, Ms., Inc. and Cheng, DDS, MD, Inc, Partnership | Oral and Maxillofacial Surgery | Past | Accepting new patients |
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.
-
- Oral and Maxillofacial Surgery (Dentist)
- Monterey, CA
- NPI 1649741190
-
- Oral and Maxillofacial Surgery (Dentist)
- Santa Cruz, CA
- NPI 1881869337
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1841304276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1663 DOMINICAN WAY",
"address_2": "SUITE 112",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "95065",
"telephone_number": "831-475-0221",
"fax_number": "831-475-3573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1663 DOMINICAN WAY",
"address_2": "SUITE 112",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "95065",
"telephone_number": "831-475-0221",
"fax_number": "831-475-3573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YELLICH",
"first_name": "GEORGE",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DDS MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "CA",
"license": "23580",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE",
"identifier": "23580",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANESTHESIA LICENSE",
"identifier": "256",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Santa Cruz, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.