Provider Demographics
NPI:1346308681
Name:YAHAV, JONATHAN Y (DDS PC)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:Y
Last Name:YAHAV
Suffix:
Gender:M
Credentials:DDS PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 N MICHIGAN AVE
Mailing Address - Street 2:WATER TOWER PLACE SUITE 976W
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611
Mailing Address - Country:US
Mailing Address - Phone:312-440-4909
Mailing Address - Fax:312-440-0111
Practice Address - Street 1:845 N MICHIGAN AVE
Practice Address - Street 2:WATER TOWER PLACE SUITE 976W
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:312-440-4909
Practice Address - Fax:312-440-0111
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL01902116111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice