MEDICARE: DR. ADRIENNE JIN HUA YU DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	14328	CT
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	22DI03087600	NJ
3	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	064856	NY

General Provider Information

NPI Number	:	1437037983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADRIENNE JIN HUA YU DDS

Provider Business Mailing Address
First Line	:	69 W 9TH ST APT 3E
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10011-8955
Country	:	US
Telephone Number	:	646-830-4770
Fax Number	:

Provider Business Practice Location Address
First Line	:	9323 AVENUE L
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-4806
Country	:	US
Telephone Number	:	718-763-0505
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2025
Last Update Date	:	08/22/2025

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