Organization
JEEVAKA YAPA DDS PC
Active
Other names
NEW CENTER ORAL & MAXILLOFACIAL SURGERY
Organization subpart
No
Provider details
NPI number
Authorized official
KANESHA CANTY (OFFICE MANAGER)
(248) 262-9100
Entity
Organization
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
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
16026
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12 3259450
—
MI
Enumeration date
03/26/2008
Last updated
09/05/2025
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