Provider Demographics
NPI:1275203622
Name:YEE, ALEXIS MIMI (DDS)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:MIMI
Last Name:YEE
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 1:9027 QUAIL COVE DR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-4031
Mailing Address - Country:US
Mailing Address - Phone:916-690-1431
Mailing Address - Fax:
Practice Address - Street 1:9450 E MISSISSIPPI AVE UNIT A
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-2427
Practice Address - Country:US
Practice Address - Phone:720-463-2766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002048781223G0001X
CA1062801223G0001X
CODEN.002048781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice