Provider Demographics
NPI:1225370216
Name:PHAIR, YONESHA VAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:YONESHA
Middle Name:VAL
Last Name:PHAIR
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 1:8039 BEAVER DAM RD
Mailing Address - Street 2:
Mailing Address - City:AUTRYVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28318-7657
Mailing Address - Country:US
Mailing Address - Phone:347-965-9872
Mailing Address - Fax:
Practice Address - Street 1:2050 SKIBO RD STE 104
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-3161
Practice Address - Country:US
Practice Address - Phone:910-605-4106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057537122300000X
NC10980122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist