Provider Demographics
NPI:1134323660
Name:YI, KLAUS M (DDS INC)
Entity Type:Individual
Prefix:
First Name:KLAUS
Middle Name:M
Last Name:YI
Suffix:
Gender:M
Credentials:DDS INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34530 BOB HOPE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1727
Mailing Address - Country:US
Mailing Address - Phone:760-324-2939
Mailing Address - Fax:760-324-3130
Practice Address - Street 1:34530 BOB HOPE DR
Practice Address - Street 2:SUITE B
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-1727
Practice Address - Country:US
Practice Address - Phone:760-324-2939
Practice Address - Fax:760-324-3130
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51004122300000X, 1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist