Provider Demographics
NPI:1801046222
Name:YU, SANDRA H (DMD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:H
Last Name:YU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3755 BROADMEAD ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-1052
Mailing Address - Country:US
Mailing Address - Phone:702-580-6459
Mailing Address - Fax:702-252-7846
Practice Address - Street 1:7670 W LAKE MEAD BLVD
Practice Address - Street 2:130
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-6649
Practice Address - Country:US
Practice Address - Phone:702-312-2273
Practice Address - Fax:702-995-0116
Is Sole Proprietor?:No
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5747122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist