Provider Demographics
NPI:1679530992
Name:YOHANNES, YONAS HN (DDS)
Entity type:Individual
Prefix:DR
First Name:YONAS
Middle Name:HN
Last Name:YOHANNES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8141 W CAMELBACK RD
Mailing Address - Street 2:STE #3
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85033-1050
Mailing Address - Country:US
Mailing Address - Phone:623-848-9100
Mailing Address - Fax:623-247-3917
Practice Address - Street 1:8141 W CAMELBACK RD
Practice Address - Street 2:STE #3
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85033-1050
Practice Address - Country:US
Practice Address - Phone:623-848-9100
Practice Address - Fax:623-247-3917
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ65011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1778675OtherUNITED CONCORDIA
AZ955130OtherAHCCCS