Provider Demographics
NPI:1073500534
Name:YAE, JOHN J (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:YAE
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:19720 68TH AVE W
Mailing Address - Street 2:SUITE #A
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4568
Mailing Address - Country:US
Mailing Address - Phone:425-776-9132
Mailing Address - Fax:425-670-0568
Practice Address - Street 1:19720 68TH AVE W
Practice Address - Street 2:SUITE #A
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4568
Practice Address - Country:US
Practice Address - Phone:425-776-9132
Practice Address - Fax:425-670-0568
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2019-03-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WADE000062431223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery