Provider Demographics
NPI:1063859841
Name:YI, SUL KI (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUL KI
Middle Name:
Last Name:YI
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 1:1600 W JONQUIL AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-3829
Mailing Address - Country:US
Mailing Address - Phone:210-723-4470
Mailing Address - Fax:
Practice Address - Street 1:206 W MAHL ST
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-4331
Practice Address - Country:US
Practice Address - Phone:956-383-4400
Practice Address - Fax:956-383-6605
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2023-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX290181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice