Healthcare Provider Details

I. General information

NPI: 1316464043
Provider Name (Legal Business Name): CALVIN YEE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2017
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 JEFFERSON BLVD STE 180
WEST SACRAMENTO CA
95605-2350
US

IV. Provider business mailing address

7915 LAGUNA BLVD STE 130
ELK GROVE CA
95758-7944
US

V. Phone/Fax

Practice location:
  • Phone: 916-403-2960
  • Fax:
Mailing address:
  • Phone: 916-776-6345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number105058
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: