Provider Demographics
NPI:1336301761
Name:YOST, ROSS ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:ALAN
Last Name:YOST
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 1:5411 N 133RD PLZ
Mailing Address - Street 2:307
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-1051
Mailing Address - Country:US
Mailing Address - Phone:605-670-3333
Mailing Address - Fax:
Practice Address - Street 1:5411 N 133RD PLZ
Practice Address - Street 2:307
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-1051
Practice Address - Country:US
Practice Address - Phone:605-670-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDD08281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice