Healthcare Provider Details

I. General information

NPI: 1972020311
Provider Name (Legal Business Name): JAMIE M. YUM, D.M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2017
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: 610-770-0210
Mailing address:
  • Phone: 610-770-0210
  • Fax: 610-770-0210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JAMIE M YUM
Title or Position: PRESIDENT
Credential: DMD
Phone: 610-770-0210