MEDICARE: DR. MICHAEL YAT SING YU 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
1	122300000X	Dentist	28495	TX

General Provider Information

NPI Number	:	1770836132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL YAT SING YU D.D.S

Provider Business Mailing Address
First Line	:	8098 MADDINGLEY AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7620
Country	:	US
Telephone Number	:	702-501-0809
Fax Number	:

Provider Business Practice Location Address
First Line	:	8098 MADDINGLEY AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7620
Country	:	US
Telephone Number	:	702-501-0809
Fax Number	:

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

Provider Enumeration Date	:	10/23/2012
Last Update Date	:	10/23/2012

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