Provider Demographics
NPI:1700586559
Name:YASSIN, RONY (DDS)
Entity Type:Individual
Prefix:
First Name:RONY
Middle Name:
Last Name:YASSIN
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 1:6500 SPID DR STE 16
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-4055
Mailing Address - Country:US
Mailing Address - Phone:361-985-8580
Mailing Address - Fax:
Practice Address - Street 1:6500 SPID DR STE 16
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-4055
Practice Address - Country:US
Practice Address - Phone:361-985-8580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-08
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX394991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice