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General NPI Number Information
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NPI Number | 1184877482
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Entity Type | Individual
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Provider Name | SOO YON UH D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 10/30/2008
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Last Update Date | 02/03/2015
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Provider Practice Location Address
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Address Line | 215 E 95TH ST 18E
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City | NEW YORK
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State | NY
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Zip | 10128-4077
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Country | US
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Telephone | 310-625-6242
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Fax |
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Provider Business Mailing Address
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Address Line | 215 E 95TH ST 18E
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City | NEW YORK
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State | NY
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Zip | 10128-4077
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Country | US
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Telephone |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 57829
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 11337
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License Number State | CT
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