Healthcare Provider Details

I. General information

NPI: 1225154248
Provider Name (Legal Business Name): YEN-HUI V LI D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 TRABUCO RD STE 130
IRVINE CA
92620-3622
US

IV. Provider business mailing address

511 EVERETT AVE # A
MONTEREY PARK CA
91755-3474
US

V. Phone/Fax

Practice location:
  • Phone: 949-551-4737
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number39834
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: