Healthcare Provider Details

I. General information

NPI: 1487856522
Provider Name (Legal Business Name): YON H LAI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 E BROADWAY FL 15
NEW YORK NY
10038-1013
US

IV. Provider business mailing address

11 E BROADWAY FL 15
NEW YORK NY
10038-1013
US

V. Phone/Fax

Practice location:
  • Phone: 212-267-1800
  • Fax: 212-267-2800
Mailing address:
  • Phone: 212-267-1800
  • Fax: 212-267-2800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number042324
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: