Individual
JEEVAKA YAPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
30555 GREENFIELD RD, SOUTHFIELD, MI 48076-1594
(248) 262-9100
(248) 262-9104
Mailing address
30555 GREENFIELD RD, SOUTHFIELD, MI 48076-1594
(248) 262-9100
(248) 262-9104
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
16026
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457523755
GROUP NPI
MI
01
—
2901016026
STATE LICENSE
MI
Enumeration date
06/07/2006
Last updated
12/19/2025
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