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General NPI Number Information
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NPI Number | 1326860685
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Entity Type | Organization
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Legal Business Name | YIDI ORTHODONTICS, LLC
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 3451 WYNDHAM WAY STE B
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City | WEST LAFAYETTE
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State | IN
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Zip | 47906-5508
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Country | US
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Telephone | 650-918-0918
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Fax |
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Provider Business Mailing Address
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Address Line | 3451 WYNDHAM WAY STE B
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City | WEST LAFAYETTE
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State | IN
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Zip | 47906-5508
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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 | OWNER
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Name | YIDI LIU
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Credential |
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Telephone | 765-801-0808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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