Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1316647100 Individual Practitioner Female Practitioner

Yanisa Alexandra Stuart Salas

Dentist - General Practice • Moody Afb, GA

Professional Overview & Biography Verified Profile Summary

Yanisa Stuart Salas is a registered healthcare professional specializing in Dentist - General Practice in Moody Afb, GA. Practice services are available at 3280 MITCHELL BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3280 Mitchell Blvd

Moody Afb, GA 316991500

Telephone 2292572778
Associated Practice Facility / Clinic
🏢 Hedera Counseling Center Facility NPI 1083296610

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Moody Afb, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.8 Yrs
Regional Practice Density
10 Specialists

Practicing in Moody Afb, GA (3302 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-08-13
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License FL DN28355

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

State License FL 37838587

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1003266073

Doctor of Osteopathic Medicine (D.O.)

Dr. Konstantine Dietrich , DDS

Dentist - General Practice

NPI 1023479888

Doctor of Dental Surgery

NPI 1023678406

Doctor of Osteopathic Medicine (D.O.)

Jerel Merida

Physician Assistant

NPI 1023807914
Dr. Samuel Oldham , PsyD

Psychologist - Clinical

NPI 1043517089

Doctor of Psychology (Psy.D.)

Austin Geer , IDMT

Military Health Care Provider - Independent Duty Medical Technicians

NPI 1063256832

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location August 13, 2024

Registered at 3280 MITCHELL BLVD, MOODY AFB, GA 316991500 (Tel: 2292572778)

📍
Updated Business Mailing Address August 13, 2024

Registered at 3280 MITCHELL BLVD, MOODY AFB, GA 316991500 (Tel: 2292572778)

NPI Profile Active March 09, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location March 09, 2023

Registered at 1395 CENTER DR, GAINESVILLE, FL 326103006 (Tel: 3522735800)

📍
Updated Business Mailing Address March 09, 2023

Registered at 361 NW 131ST AVE, PLANTATION, FL 333252215

👤
Provider Name / Credentials Updated March 09, 2023

Recorded as YANISA STUART SALAS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 09, 2023

Student in an Organized Health Care Education/Training Program (License #37838587 in FL)

🟢
Initial NPI Registration & Enumeration March 09, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1316647100
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 09, 2023
Last Update: August 13, 2024
Sole Proprietor: Yes

Mailing Address

3280 Mitchell Blvd

Moody Afb, GA 316991500

Phone: 2292572778

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.