Individual provider Active NPI

Marc S. Yasoni, D.D.S.

  • General Practice Dentistry
  • Westminster, CO
National Provider Identifier
1891710992
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7691 Issued in CO
Practice address
11187 Sheridan Blvd
Unit 12
Westminster, CO 80020-3231
Phone
(303) 469-2333
Fax
(303) 469-2011
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7691 CO Primary

Addresses

Primary practice location

11187 Sheridan Blvd
Unit 12
Westminster, CO 80020-3231

Mailing address

11187 Sheridan Blvd
Unit 12
Westminster, CO 80020-3231
Phone (303) 469-2333

Other identifiers 1

IdentifierTypeStateIssuer
02076917MedicaidCO

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
I20160212001518 CO Order and Referring Only - DentistPractitioner - Dentist 3870897721

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7691COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
North Westminster Dental Partners, LLP General Practice Past Accepting new patients

Organizations & group practices 1

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891710992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11187 SHERIDAN BLVD",
            "address_2": "UNIT 12",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800203231",
            "telephone_number": "303-469-2333",
            "fax_number": "303-469-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11187 SHERIDAN BLVD",
            "address_2": "UNIT 12",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800203231",
            "telephone_number": "303-469-2333",
            "fax_number": "303-469-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YASONI",
        "first_name": "MARC",
        "middle_name": "S.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "7691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02076917",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CO

Sources for this page

Verify at the official NPI Registry.