Provider Demographics
NPI:1578092136
Name:YEH, DEBORAH (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:YEH
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 1:6906 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-2220
Mailing Address - Country:US
Mailing Address - Phone:301-801-1105
Mailing Address - Fax:
Practice Address - Street 1:8140 STONEWALL SHOPS SQ
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3891
Practice Address - Country:US
Practice Address - Phone:571-298-8279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1857663122300000X
390200000X
VA04014174561223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program