Simon Yakligian, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D9980 Issued in OR

Practice address

4765 Village Plaza Loop Ste 101
Eugene, OR 97401-6676

Phone

(541) 681-9999

NPI assigned

Jul 26, 2006

Last updated

Dec 15, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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.

• Harmony Dental LLC

  • Dental Clinic/Center
  • Eugene, OR
  • NPI 1497629646
  NPD
• Tae Een Park,D.D.S.,Inc

  • Dental Clinic/Center
  • Oakdale, CA
  • NPI 1063889558
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1952324378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4765 VILLAGE PLAZA LOOP STE 101",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016676",
            "telephone_number": "541-681-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4765 VILLAGE PLAZA LOOP STE 101",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016676",
            "telephone_number": "541-681-9999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "190 S Oak Ave Ste 3-6",
            "address_purpose": "LOCATION",
            "city": "Oakdale",
            "state": "CA",
            "postal_code": "953613541",
            "country_code": "US",
            "telephone_number": "209-847-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAKLIGIAN",
        "first_name": "SIMON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53298",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yanan Xue, RDN, LD
• Ariel Yabek, M.A.
• Kyndal Yada
• Trishia Yada
• Carol Yahner, LMT
• Anthony Marcus Yakovich
• Alexis Yalon, MA, MS
• Steven Douglas Yamamori, QMHA-R
• Elizabeth Yamron
• Ellyn Yandel

• General Practice Dentistry in Eugene, OR
• Providers in Eugene, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.