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NPI Code Detail

MEDICARE: DR. PETER YI D.D.S.

MEDICARE:  DR. PETER  YI  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry04041412452VA

General Provider Information

NPI Number : 1114031309
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER YI D.D.S.
Provider Business Mailing Address
First Line : 7530 LIMESTONE DR
Second Line :
City : GAINESVILLE
State : VA
Zip : 20155-4005
Country : US
Telephone Number : 917-282-4764
Fax Number :
Provider Business Practice Location Address
First Line : 7530 LIMESTONE DR
Second Line :
City : GAINESVILLE
State : VA
Zip : 20155-4005
Country : US
Telephone Number : 571-261-9117
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2006
Last Update Date : 06/21/2013

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Directions to “ DR. PETER YI D.D.S.” Practice Location

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