Provider Demographics
NPI:1972854438
Name:CLEVELAND, JOY YVONNE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOY
Middle Name:YVONNE
Last Name:CLEVELAND
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 1:11965 PELLICANO DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-6829
Mailing Address - Country:US
Mailing Address - Phone:915-855-2337
Mailing Address - Fax:
Practice Address - Street 1:11965 PELLICANO DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-6829
Practice Address - Country:US
Practice Address - Phone:915-855-2337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX280611223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDO NOT HAVE A NUMBEROtherI DO NOT HAVE A NUMBER.