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General NPI Number Information
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NPI Number | 1699269522
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Entity Type | Individual
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Provider Name | JESSICA HAEUN YI DMD
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Gender | Female
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Dates
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Enumeration Date | 06/14/2018
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 11125 JONES BRIDGE RD STE 200
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City | ALPHARETTA
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State | GA
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Zip | 30022-0002
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Country | US
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Telephone | 770-676-1143
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Fax |
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Provider Business Mailing Address
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Address Line | 11125 JONES BRIDGE RD STE 200
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City | ALPHARETTA
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State | GA
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Zip | 30022-0002
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Country | US
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Telephone | 770-676-1143
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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 | DS042041
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 22DI02794900
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN123608
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License Number State | GA
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