Provider Demographics
NPI:1760799068
Name:SUH, YE JOON (DDS)
Entity Type:Individual
Prefix:
First Name:YE JOON
Middle Name:
Last Name:SUH
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 1:2016 HUNTCLIFFE CT
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-4723
Mailing Address - Country:US
Mailing Address - Phone:310-739-3791
Mailing Address - Fax:214-764-0166
Practice Address - Street 1:3420 K AVE STE 140
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-2329
Practice Address - Country:US
Practice Address - Phone:972-424-8023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59631122300000X
TX25702122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist