Provider Demographics
NPI:1477808178
Name:YAP GOMEZ, HASAN G (DDS)
Entity type:Individual
Prefix:
First Name:HASAN
Middle Name:G
Last Name:YAP GOMEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 E COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-3391
Mailing Address - Country:US
Mailing Address - Phone:954-772-2000
Mailing Address - Fax:954-772-0614
Practice Address - Street 1:701 E COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-3391
Practice Address - Country:US
Practice Address - Phone:954-772-2000
Practice Address - Fax:954-772-0614
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20579122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist