Provider Demographics
NPI:1619365939
Name:YOST, LESLEE A
Entity Type:Individual
Prefix:
First Name:LESLEE
Middle Name:A
Last Name:YOST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LESLEE
Other - Middle Name:A
Other - Last Name:YOST
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHRDH
Mailing Address - Street 1:201 LEGGE LK
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:NE
Mailing Address - Zip Code:68649-2005
Mailing Address - Country:US
Mailing Address - Phone:402-672-7299
Mailing Address - Fax:402-652-8434
Practice Address - Street 1:201 LEGGE LK
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:NE
Practice Address - Zip Code:68649-2005
Practice Address - Country:US
Practice Address - Phone:402-672-7299
Practice Address - Fax:402-652-8434
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE70124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist