Provider Demographics
NPI:1508477670
Name:YASHEWSKI, RENATA (DMD)
Entity Type:Individual
Prefix:
First Name:RENATA
Middle Name:
Last Name:YASHEWSKI
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 1:3815 WADSWORTH BLVD
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-4612
Mailing Address - Country:US
Mailing Address - Phone:440-525-4053
Mailing Address - Fax:
Practice Address - Street 1:3815 WADSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4612
Practice Address - Country:US
Practice Address - Phone:720-536-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV73831223G0001X
CODEN.002046251223G0001X
OH30.027377122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice