MEDICARE: JASON W YU DMD MD

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	2086S0122X	Plastic and Reconstructive Surgery Physician	278199	MA
2	2086S0122X	Plastic and Reconstructive Surgery Physician	DR.0067992	CO
3	2086S0122X	Plastic and Reconstructive Surgery Physician	ME179941	FL
4	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	A170353	CA
5	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	278199	MA

General Provider Information

NPI Number	:	1316176159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON W YU DMD MD

Provider Business Mailing Address
First Line	:	265 E ROLLINS ST STE 4700
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-5534
Country	:	US
Telephone Number	:	407-821-3655
Fax Number	:

Provider Business Practice Location Address
First Line	:	265 E ROLLINS ST STE 4700
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-5534
Country	:	US
Telephone Number	:	407-821-3655
Fax Number	:

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

Provider Enumeration Date	:	07/14/2009
Last Update Date	:	06/01/2026

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