Provider Demographics
NPI:1215083639
Name:YBARRA, JOANN (DDS)
Entity type:Individual
Prefix:DR
First Name:JOANN
Middle Name:
Last Name:YBARRA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 E HILDEBRAND AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212
Mailing Address - Country:US
Mailing Address - Phone:210-820-0400
Mailing Address - Fax:210-820-0042
Practice Address - Street 1:235 E HILDEBRAND AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212
Practice Address - Country:US
Practice Address - Phone:210-820-0400
Practice Address - Fax:210-820-0042
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13395122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist