Provider Demographics
NPI:1114671674
Name:JESSICA L YIM DMD
Entity Type:Organization
Organization Name:JESSICA L YIM DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:YIM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:614-843-0915
Mailing Address - Street 1:1010 N 21ST ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-2984
Mailing Address - Country:US
Mailing Address - Phone:740-366-5353
Mailing Address - Fax:
Practice Address - Street 1:1010 N 21ST ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-2984
Practice Address - Country:US
Practice Address - Phone:740-366-5353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty