Provider Demographics
NPI:1215328356
Name:ANGELL, YIMAR (DMD)
Entity type:Individual
Prefix:DR
First Name:YIMAR
Middle Name:
Last Name:ANGELL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6142 TURNBURY PARK DR APT 5206
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-6137
Mailing Address - Country:US
Mailing Address - Phone:857-400-6888
Mailing Address - Fax:
Practice Address - Street 1:9126 TOWN CENTER PKWY STE 101
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-5052
Practice Address - Country:US
Practice Address - Phone:941-236-5695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-11
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1858216122300000X, 1223E0200X, 1223G0001X
FLDN23958122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223E0200XDental ProvidersDentistEndodontics
No1223G0001XDental ProvidersDentistGeneral Practice