Provider Demographics
NPI:1306096797
Name:JAMES FM YANNEY DDS MD
Entity type:Organization
Organization Name:JAMES FM YANNEY DDS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:FM
Authorized Official - Last Name:YANNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-722-4377
Mailing Address - Street 1:1672 WILLAMETTE FALLS DR
Mailing Address - Street 2:SUITE #D
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-4661
Mailing Address - Country:US
Mailing Address - Phone:503-722-4377
Mailing Address - Fax:503-722-4413
Practice Address - Street 1:1672 WILLAMETTE FALLS DR
Practice Address - Street 2:SUITE #D
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-4661
Practice Address - Country:US
Practice Address - Phone:503-722-4377
Practice Address - Fax:503-722-4413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD15327204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1104991363OtherNPI