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General NPI Number Information
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NPI Number | 1063865285
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Entity Type | Individual
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Provider Name | DEBORAH YIM
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Gender | Female
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Dates
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Enumeration Date | 07/22/2016
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Last Update Date | 12/24/2024
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Provider Practice Location Address
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Address Line | 1500 BAUERLE RD. BLDG 100, SUITE B
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City | HAMMOND
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State | LA
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Zip | 70403
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Country | US
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Telephone | 985-510-2654
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Fax | 985-510-2655
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Provider Business Mailing Address
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Address Line | 1459 AZTEC AVE
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City | METAIRIE
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State | LA
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Zip | 70005-1205
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Country | US
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Telephone | 224-217-7110
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 6692
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License Number State | LA
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