Provider Demographics
NPI:1386023257
Name:YOU, JULIA JIAE (DDS)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:JIAE
Last Name:YOU
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 1:15 OREGON AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-7461
Mailing Address - Country:US
Mailing Address - Phone:253-475-0262
Mailing Address - Fax:
Practice Address - Street 1:15 OREGON AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-7461
Practice Address - Country:US
Practice Address - Phone:253-475-0262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE605467751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice