DR. JOHN M YACCINO (NPI# 1255326856) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1255326856 |
Entity Type | Individual |
Full Name | DR. JOHN M YACCINO |
Credential | DDS |
Practice Address |
310 W Losey St 375 Dental Squadron Scott Afb IL 62225-5250 |
Mailing Address |
779 White Horse Ln O Fallon IL 62269-6833 |
Practice Telephone | 6182566667 |
Mailing Telephone | 6186289907 |
Enumeration Date | 2005-09-20 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | X |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223E0200X |
Dentist Specialization: Endodontics |
IL | Dental Providers |
Street Address |
310 W LOSEY ST 375 DENTAL SQUADRON |
City | SCOTT AFB |
State | IL |
Zip Code | 62225-5250 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205839727 | Toney L Banks | Nurse Anesthetist, Certified Registered | 310 W Losey St, Scott Afb, IL 62225-5250 | 2005-05-30 |
1841814852 | Hilary Elizabeth Parsons | Student in an Organized Health Care Education/Training Program | 310 W Losey St, Scott Afb, IL 62225-5250 | 2020-06-04 |
1447874722 | Mauranda Nikki Bembry | Social Worker | 310 W Losey St, Scott Afb, IL 62225-5250 | 2020-06-03 |
1437778016 | Mark Alan Underhill | Military Health Care Provider | 310 W Losey St, Scott Afb, IL 62225-5250 | 2020-04-13 |
1194353276 | Kolin Daniel Cookson | Student in an Organized Health Care Education/Training Program | 310 W Losey St, Scott Afb, IL 62225-5250 | 2020-04-01 |
1831723592 | Linh Thuy Truong | Dentist | 310 W Losey St, Scott Afb, IL 62225-5250 | 2020-03-02 |
1346890894 | Crystal June Garcia | Military Health Care Provider | 310 W Losey St, Scott Afb, IL 62225-5250 | 2019-09-17 |
1740835602 | Andres Alejandro Paredes | Physician Assistant | 310 W Losey St, Scott Afb, IL 62225-5250 | 2019-08-07 |
1215580386 | Ryan Taylor Blalock | Military Health Care Provider | 310 W Losey St, Scott Afb, IL 62225-5250 | 2019-07-18 |
1063975001 | Collin Schroeder | Military Health Care Provider | 310 W Losey St, Scott Afb, IL 62225-5250 | 2019-04-08 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861011645 | Cheryl D Jones | Registered Nurse | 375th Mdg, 310 W. Losey Street, Scott Afb, IL 62225 | 2020-04-13 |
1649836123 | Benjamin Truong | Student in an Organized Health Care Education/Training Program | Scott Air Force Base, 307 West Losey Street Building #1535, Apo, AA 62225 | 2019-05-10 |
1558925669 | Brian Ng | Student in an Organized Health Care Education/Training Program | South Drive, Scott Afb, Illinois, Apo, AA 62225 | 2019-04-24 |
1841853710 | Lance Scott Mcgavin | Student in an Organized Health Care Education/Training Program | 307 West Losey Street., Building #1535, Scott Afb, IL 62225 | 2019-04-17 |
1629503180 | Joshua Bryce Kessack | General Practice | 375 Amds, 310 Losey St, Scott Afb, IL 62225 | 2017-04-21 |
1265988059 | Jennifer Nicole Laurence | Dentist | 703 Seibert Rd Ste 5, Scott Afb, IL 62225 | 2016-08-31 |
1578940755 | Usv Optical Inc | Eyewear Supplier (Equipment, not the service) | 207 W. Winters St., Bldg 1981, Scott Afb, IL 62225 | 2015-04-27 |
1891193652 | Diana Meyer | Social Worker | Scott Afb, Apo, AA 62225 | 2014-12-10 |
1801210273 | Robie Victoria Hughes | Registered Nurse | 310 W Losey Street, Scott Air Force Base, IL 62225 | 2014-02-06 |
1487998746 | Melissa Dawn Goff | Military Health Care Provider | 310 West. Losey Street, Scott Afb, IL 62225 | 2012-11-26 |
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Taxonomy Code | 1223E0200X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Endodontics |
The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124368584 | Scott Bryant | Dentist | 375 Mdg, 310 W. Losey Street, Scott Afb, IL 62225 | 2013-02-22 |
1568748168 | Amber Miller | Dentist | 375th Medical Group, 310 West Losey Street, Scott Afb, IL 62225 | 2011-10-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669089777 | Sebastian Przybylo, Dmd, Pllc | Dentist | 350 S Northwest Hwy Ste 116, Park Ridge, IL 60068-4262 | 2020-09-24 |
1770126740 | Old Orchard Endodontics | Dentist | 4905 Old Orchard Ctr Ste 216, Skokie, IL 60077-4741 | 2019-10-23 |
1194380741 | Vasiliki Kytridou | Dentist | 2800 College Avenue Southern Il University School of De, Building 285, Alton, IL 62002 | 2019-05-08 |
1134782592 | Endodontics of Springfield | Dentist | 997 Clock Tower Dr Ste C, Springfield, IL 62704-1399 | 2019-04-20 |
1942793815 | Millennium Dental Specialist | Dentist | 1624 W Division St Ste B, Chicago, IL 60622-3908 | 2018-06-14 |
1588163364 | Advanced Endodontics, PC | Dentist | 103 S. Greenleaf Street, Suite K, Gurnee, IL 60031 | 2018-02-07 |
1518488055 | Seth Thomas Barnett | Dentist | 3601 General Electric Rd Ste 6, Bloomington, IL 61704-8566 | 2017-07-06 |
1023562857 | Jwwdental LLC | Dentist | 808 E Woodfield Rd, Suite 300, Schaumburg, IL 60173-4816 | 2016-08-10 |
1629453378 | Charles Richard Neach | Dentist | 801 S Paulina St Rm 302a, Chicago, IL 60612-7210 | 2015-07-23 |
1619360096 | Rajan Sharma | Dentist | 6319 Fairview Ave Ste 103, Westmont, IL 60559-2889 | 2015-03-10 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.