Provider Demographics
NPI:1003011123
Name:MATRACIA, YOON-MI (DMD)
Entity Type:Individual
Prefix:
First Name:YOON-MI
Middle Name:
Last Name:MATRACIA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5003 ASPEN PINE BLVD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-9335
Mailing Address - Country:US
Mailing Address - Phone:310-902-5927
Mailing Address - Fax:614-761-3398
Practice Address - Street 1:100 N HIGH ST
Practice Address - Street 2:SUITE D
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-2155
Practice Address - Country:US
Practice Address - Phone:614-761-3361
Practice Address - Fax:614-761-3398
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300225331223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry