Provider Demographics
NPI:1164403440
Name:LEE, YAR YIN (DDS)
Entity Type:Individual
Prefix:
First Name:YAR YIN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13911 FRANKLIN AVE
Mailing Address - Street 2:1 FL
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3342
Mailing Address - Country:US
Mailing Address - Phone:718-831-8325
Mailing Address - Fax:917-563-5479
Practice Address - Street 1:13911 FRANKLIN AVE
Practice Address - Street 2:1 FL
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3342
Practice Address - Country:US
Practice Address - Phone:718-831-8325
Practice Address - Fax:917-563-5479
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0416681223P0221X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01334234Medicaid