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General NPI Number Information
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NPI Number | 1760860290
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Entity Type | Individual
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Provider Name | DASOM YU DDS
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Gender | Female
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Dates
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Enumeration Date | 05/17/2015
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Last Update Date | 03/06/2020
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Provider Practice Location Address
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Address Line | 10 WATERSIDE PLZ APT 8E
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City | NEW YORK
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State | NY
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Zip | 10010-2610
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Country | US
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Telephone | 713-478-9227
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Fax |
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Provider Business Mailing Address
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Address Line | 271 W 47TH ST APT 52H
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City | NEW YORK
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State | NY
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Zip | 10036-1459
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Country | US
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Telephone | 713-478-9227
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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 | 058832
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License Number State | NY
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