Healthcare Provider Details

I. General information

NPI: 1144341116
Provider Name (Legal Business Name): BRIAN JAMES YEE D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 E 12TH ST STE#212
CLEVELAND OH
44114-3500
US

IV. Provider business mailing address

1801 E 12TH ST STE#212
CLEVELAND OH
44114-3500
US

V. Phone/Fax

Practice location:
  • Phone: 216-621-6991
  • Fax: 216-621-6725
Mailing address:
  • Phone: 216-621-6991
  • Fax: 216-621-6725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30017718
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: