Healthcare Provider Details

I. General information

NPI: 1023211992
Provider Name (Legal Business Name): FIONA S YEUNG D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 02/08/2021
Certification Date: 02/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 E 46TH ST RM 1300
NEW YORK NY
10017-9245
US

IV. Provider business mailing address

20 E 46TH ST RM 1300
NEW YORK NY
10017-9245
US

V. Phone/Fax

Practice location:
  • Phone: 212-883-0100
  • Fax: 917-633-7396
Mailing address:
  • Phone: 212-883-0100
  • Fax: 917-633-7396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number50053616
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: