Provider Demographics
NPI:1508945304
Name:YASH, THOMAS F (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:F
Last Name:YASH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:F
Other - Last Name:YASH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS, INC
Mailing Address - Street 1:1056 DELTA AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-3160
Mailing Address - Country:US
Mailing Address - Phone:513-321-6044
Mailing Address - Fax:513-732-1200
Practice Address - Street 1:1056 DELTA AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-3160
Practice Address - Country:US
Practice Address - Phone:513-321-6044
Practice Address - Fax:513-732-1200
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300150061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0410826Medicaid
OH27-1546063OtherEIN