Provider Demographics
NPI:1326299942
Name:YASMIN EASLEY DENTAL CORPORATION
Entity Type:Organization
Organization Name:YASMIN EASLEY DENTAL CORPORATION
Other - Org Name:GATEWAY DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ONWER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:YASMIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:EASLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:661-236-0046
Mailing Address - Street 1:2860 MICHELLE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-1009
Mailing Address - Country:US
Mailing Address - Phone:714-508-3600
Mailing Address - Fax:714-368-2092
Practice Address - Street 1:38209 47TH ST E
Practice Address - Street 2:SUITE E
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93552-3113
Practice Address - Country:US
Practice Address - Phone:661-236-0046
Practice Address - Fax:661-285-1978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty