Provider Demographics
NPI:1497250054
Name:YJK ASSOCIATES PA
Entity Type:Organization
Organization Name:YJK ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YANGHOE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-245-2483
Mailing Address - Street 1:1111 W FRANKFORD RD STE 101
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-4921
Mailing Address - Country:US
Mailing Address - Phone:972-245-2483
Mailing Address - Fax:
Practice Address - Street 1:1111 W FRANKFORD RD STE 101
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-4921
Practice Address - Country:US
Practice Address - Phone:972-245-2483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX316421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1114902103OtherNPPES