Provider Demographics
NPI:1629136080
Name:YEE, WINSTON F (DDS)
Entity Type:Individual
Prefix:
First Name:WINSTON
Middle Name:F
Last Name:YEE
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 1:17760 HESPERIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN LORENZO
Mailing Address - State:CA
Mailing Address - Zip Code:94580
Mailing Address - Country:US
Mailing Address - Phone:510-276-8760
Mailing Address - Fax:510-276-8782
Practice Address - Street 1:17760 HESPERIAN BLVD
Practice Address - Street 2:
Practice Address - City:SAN LORENZO
Practice Address - State:CA
Practice Address - Zip Code:94580
Practice Address - Country:US
Practice Address - Phone:510-276-8760
Practice Address - Fax:510-276-8782
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25657122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB2565701OtherDENTICAL