Provider Demographics
NPI:1043833742
Name:YAHIRO, ANNE (DDS)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:
Last Name:YAHIRO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 147TH ST W STE 302
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-7538
Mailing Address - Country:US
Mailing Address - Phone:952-432-9155
Mailing Address - Fax:
Practice Address - Street 1:7300 147TH ST W STE 302
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7538
Practice Address - Country:US
Practice Address - Phone:952-432-9155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-28
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND144681223G0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program