Healthcare Provider Details

I. General information

NPI: 1164782173
Provider Name (Legal Business Name): JAMIE M. YUM D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JAMIE M YUM D.M.D.

II. Dates (important events)

Enumeration Date: 05/23/2012
Last Update Date: 07/21/2022
Certification Date: 09/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1251 S CEDAR CREST BLVD STE 306
ALLENTOWN PA
18103-6253
US

IV. Provider business mailing address

1251 S CEDAR CREST BLVD STE 306
ALLENTOWN PA
18103-6253
US

V. Phone/Fax

Practice location:
  • Phone: 610-770-0210
  • Fax:
Mailing address:
  • Phone: 610-770-0210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDS039109
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: