Provider Demographics
NPI:1881401966
Name:AGUILERA, YANIRA (RDH)
Entity type:Individual
Prefix:
First Name:YANIRA
Middle Name:
Last Name:AGUILERA
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5515 W 38TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-2995
Mailing Address - Country:US
Mailing Address - Phone:317-880-0080
Mailing Address - Fax:317-880-0079
Practice Address - Street 1:5515 W 38TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-2995
Practice Address - Country:US
Practice Address - Phone:317-880-0080
Practice Address - Fax:317-880-0079
Is Sole Proprietor?:No
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN13007257A124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist