Provider Demographics
NPI:1013006345
Name:YU, DAVID T (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:T
Last Name:YU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5716 BELLAIRE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-5512
Mailing Address - Country:US
Mailing Address - Phone:713-668-1600
Mailing Address - Fax:713-668-1640
Practice Address - Street 1:5716 BELLAIRE BLVD STE B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-5512
Practice Address - Country:US
Practice Address - Phone:713-668-1600
Practice Address - Fax:713-668-1640
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19593122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX009591104Medicaid