Provider Demographics
NPI:1295218840
Name:YMAS, JAYSEN JEROME LOPEZ (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAYSEN JEROME
Middle Name:LOPEZ
Last Name:YMAS
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 1:150 LAURA ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-4012
Mailing Address - Country:US
Mailing Address - Phone:415-994-0978
Mailing Address - Fax:
Practice Address - Street 1:9 SILLIMAN ST STE 1
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94134-1200
Practice Address - Country:US
Practice Address - Phone:415-468-1777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1031861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice