Provider Demographics
NPI:1598402182
Name:YOHMAN, KEITH (DMD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:
Last Name:YOHMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1344 LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-2136
Mailing Address - Country:US
Mailing Address - Phone:614-866-1234
Mailing Address - Fax:
Practice Address - Street 1:1344 LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-2136
Practice Address - Country:US
Practice Address - Phone:614-866-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.026831122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist