MEDICARE: MISS JENNY YEUP DENTAL HYGIENIST

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	124Q00000X	Dental Hygienist	023890	NY

General Provider Information

NPI Number	:	1639231624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JENNY YEUP DENTAL HYGIENIST

Provider Business Mailing Address
First Line	:	14201 41ST AVE APT 511
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11355-2415
Country	:	US
Telephone Number	:	718-358-8646
Fax Number	:

Provider Business Practice Location Address
First Line	:	3411 VERNON BLVD
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11106-5121
Country	:	US
Telephone Number	:	718-726-8484
Fax Number	:

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

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	07/08/2007

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