Healthcare Provider Details

I. General information

NPI: 1497046288
Provider Name (Legal Business Name): YEUNG'S DENTAL CARE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2011
Last Update Date: 04/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 CENTRE ST SUITE 602
NEW YORK NY
10013-4552
US

IV. Provider business mailing address

139 CENTRE ST SUITE 602
NEW YORK NY
10013-4552
US

V. Phone/Fax

Practice location:
  • Phone: 212-966-5726
  • Fax: 212-966-0374
Mailing address:
  • Phone: 212-966-5726
  • Fax: 212-966-0374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number050392
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number049940
License Number StateNY

VIII. Authorized Official

Name: MS. SAMMI YEUNG
Title or Position: PRESIDENT
Credential: DDS
Phone: 212-966-5726