Provider Demographics
NPI:1619578655
Name:PINOLE ENDODONTICS
Entity Type:Organization
Organization Name:PINOLE ENDODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YULING
Authorized Official - Middle Name:
Authorized Official - Last Name:YEH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:510-964-0215
Mailing Address - Street 1:2150 APPIAN WAY STE 207
Mailing Address - Street 2:
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-2520
Mailing Address - Country:US
Mailing Address - Phone:510-964-0215
Mailing Address - Fax:
Practice Address - Street 1:2150 APPIAN WAY STE 207
Practice Address - Street 2:
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-2520
Practice Address - Country:US
Practice Address - Phone:510-964-0215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty