Healthcare Provider Details

I. General information

NPI: 1841499928
Provider Name (Legal Business Name): YON H. LAI, DDS,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 07/17/2007
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: DR. YON H LAI
Title or Position: PRESIDENT
Credential: DDS
Phone: 212-267-1800