Healthcare Provider Details

I. General information

NPI: 1649931205
Provider Name (Legal Business Name): YE SHI D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2022
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13065 E 17TH AVE FL 1
AURORA CO
80045-2532
US

IV. Provider business mailing address

801 S CHERRY ST
DENVER CO
80246-2634
US

V. Phone/Fax

Practice location:
  • Phone: 303-724-5505
  • Fax:
Mailing address:
  • Phone: 347-933-3424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberAD.0000533
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number000122
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number0401417635
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: