Provider Demographics
NPI:1821340001
Name:YU, ANDY C A (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDY
Middle Name:C A
Last Name:YU
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 1:22525 SE 64TH PL STE 170
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-8971
Mailing Address - Country:US
Mailing Address - Phone:425-837-0383
Mailing Address - Fax:425-837-0710
Practice Address - Street 1:22525 SE 64TH PL STE 170
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027
Practice Address - Country:US
Practice Address - Phone:425-837-0383
Practice Address - Fax:425-837-0710
Is Sole Proprietor?:No
Enumeration Date:2012-10-11
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA605999431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice