Provider Demographics
NPI:1497973317
Name:THIO, YURITA H (DDS)
Entity Type:Individual
Prefix:DR
First Name:YURITA
Middle Name:H
Last Name:THIO
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 1:3090 COCHRAN ST STE E
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-2795
Mailing Address - Country:US
Mailing Address - Phone:805-955-0181
Mailing Address - Fax:818-831-9511
Practice Address - Street 1:3090 COCHRAN ST STE E
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-2795
Practice Address - Country:US
Practice Address - Phone:805-955-0181
Practice Address - Fax:818-831-9511
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40030122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist