Provider Demographics
NPI:1497317234
Name:YI, EDDIE YU-KUANG (DDS)
Entity Type:Individual
Prefix:
First Name:EDDIE
Middle Name:YU-KUANG
Last Name:YI
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 1:7221 RAGAN PL
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-1232
Mailing Address - Country:US
Mailing Address - Phone:214-693-7654
Mailing Address - Fax:
Practice Address - Street 1:5017 TEASLEY LN STE 165
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-3895
Practice Address - Country:US
Practice Address - Phone:940-387-4597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35294122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist