Provider Demographics
NPI:1609964550
Name:YOU, JYH-SHYAN
Entity Type:Individual
Prefix:
First Name:JYH-SHYAN
Middle Name:
Last Name:YOU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1172 BEACON ST
Mailing Address - Street 2:# 104
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02461-1146
Mailing Address - Country:US
Mailing Address - Phone:617-969-5567
Mailing Address - Fax:617-969-5567
Practice Address - Street 1:1172 BEACON ST
Practice Address - Street 2:# 104
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02461-1146
Practice Address - Country:US
Practice Address - Phone:617-969-5567
Practice Address - Fax:617-969-5567
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA176321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice