Provider Demographics
NPI:1457686297
Name:SCOTT, YVONDIA M (DMD)
Entity Type:Individual
Prefix:DR
First Name:YVONDIA
Middle Name:M
Last Name:SCOTT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10222 SAGEPLUM DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-5108
Mailing Address - Country:US
Mailing Address - Phone:224-558-4198
Mailing Address - Fax:
Practice Address - Street 1:5342 E US HIGHWAY 83
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-9431
Practice Address - Country:US
Practice Address - Phone:956-317-1365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6015122300000X
SC71151223G0001X
VA004014128001223G0001X
TX400551223G0001X
IL019.03.1973122300000X
KS61589122300000X
GADN014009122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist