Healthcare Provider Details

I. General information

NPI: 1275203622
Provider Name (Legal Business Name): ALEXIS MIMI YEE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2021
Last Update Date: 03/28/2022
Certification Date: 03/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9450 E MISSISSIPPI AVE UNIT A
DENVER CO
80247-2427
US

IV. Provider business mailing address

9027 QUAIL COVE DR
ELK GROVE CA
95624-4031
US

V. Phone/Fax

Practice location:
  • Phone: 720-463-2766
  • Fax:
Mailing address:
  • Phone: 916-690-1431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number00204878
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number106280
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN.00204878
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: