Individual
JEEVAKA YAPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
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
Update your record
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