Provider Demographics
NPI:1003004888
Name:YUEN, NORMA (DDS)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:
Last Name:YUEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 122223
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91912-6923
Mailing Address - Country:US
Mailing Address - Phone:619-454-4342
Mailing Address - Fax:
Practice Address - Street 1:DEFENSORES DE BAJA CALIFORNIA #702
Practice Address - Street 2:COLONIA RUIZ CORTINEZ
Practice Address - City:TIJUANA
Practice Address - State:BAJA CALIFORNIA
Practice Address - Zip Code:22350
Practice Address - Country:MX
Practice Address - Phone:52664-682-5234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-05
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA936451122300000X, 1223E0200X, 1223G0001X, 1223P0106X, 1223P0221X, 1223P0300X, 1223P0700X, 1223S0112X, 1223X0008X, 1223X0400X, 122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
No1223E0200XDental ProvidersDentistEndodontics
No1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
No1223P0221XDental ProvidersDentistPediatric Dentistry
No1223P0300XDental ProvidersDentistPeriodontics
No1223P0700XDental ProvidersDentistProsthodontics
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223X0008XDental ProvidersDentistOral and Maxillofacial Radiology
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122400000XDental ProvidersDenturist