Provider Demographics
NPI:1891955480
Name:REEVES, YAMIL (DMD)
Entity Type:Individual
Prefix:MR
First Name:YAMIL
Middle Name:
Last Name:REEVES
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 1:5925 LINDA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-0000
Mailing Address - Country:US
Mailing Address - Phone:787-967-3972
Mailing Address - Fax:
Practice Address - Street 1:1745 EASTLAKE PKWY
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91915-2033
Practice Address - Country:US
Practice Address - Phone:619-421-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64003122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist