MEDICARE: YIE LIN UM

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
1	122300000X	Dentist	7762	LA
2	1223G0001X	General Practice Dentistry	8065	NV

General Provider Information

NPI Number	:	1235804220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YIE LIN UM

Provider Business Mailing Address
First Line	:	1001 SHADOW LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4124
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4325 AIRLINE DR
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-2003
Country	:	US
Telephone Number	:	318-742-9333
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2021
Last Update Date	:	06/15/2026

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Directions to “ YIE LIN UM ” Practice Location

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