Provider Demographics
NPI:1205843133
Name:LUO, STEVEN YEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:YEE
Last Name:LUO
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 1:629 9TH ST
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:91932-1508
Mailing Address - Country:US
Mailing Address - Phone:619-424-5115
Mailing Address - Fax:619-628-8129
Practice Address - Street 1:629 9TH ST
Practice Address - Street 2:
Practice Address - City:IMPERIAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:91932-1508
Practice Address - Country:US
Practice Address - Phone:619-424-5115
Practice Address - Fax:619-628-8129
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA452861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice