Individual provider Active NPI

George Michael Yellich, DDS MS

  • Oral and Maxillofacial Surgery (Dentist)
  • Santa Cruz, CA
National Provider Identifier
1841304276
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
23580 Issued in CA
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

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
23580OtherCADENTAL LICENSE
256OtherCAANESTHESIA 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
Green means eligible to order or refer.
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

LicenseStateTypeSpecialty
23580CAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.