Provider Demographics
NPI:1992851943
Name:YONASH, DENNIS PAUL (OD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:PAUL
Last Name:YONASH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BENTLEYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15314-1118
Mailing Address - Country:US
Mailing Address - Phone:724-239-2010
Mailing Address - Fax:724-239-2010
Practice Address - Street 1:1000 MAIN ST
Practice Address - Street 2:
Practice Address - City:BENTLEYVILLE
Practice Address - State:PA
Practice Address - Zip Code:15314-1118
Practice Address - Country:US
Practice Address - Phone:724-239-2010
Practice Address - Fax:724-239-2010
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA5193P152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAY01462158OtherBLUE SHIELD MEDICAL
PA0016640500001Medicaid
917742OtherEYE MED
PA0562000001Medicare NSC
PA0016640500001Medicaid
917742OtherEYE MED