Provider Demographics
NPI:1841401932
Name:YU, MING SHENG (DDS)
Entity Type:Individual
Prefix:
First Name:MING
Middle Name:SHENG
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 1:12906 STATE ROUTE 664 S
Mailing Address - Street 2:SUITE A7
Mailing Address - City:LOGAN
Mailing Address - State:OH
Mailing Address - Zip Code:43138-9260
Mailing Address - Country:US
Mailing Address - Phone:567-224-8745
Mailing Address - Fax:
Practice Address - Street 1:12906 STATE ROUTE 664 S
Practice Address - Street 2:SUITE A7
Practice Address - City:LOGAN
Practice Address - State:OH
Practice Address - Zip Code:43138-9260
Practice Address - Country:US
Practice Address - Phone:567-224-8745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0230031223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3076228Medicaid
OH4305161Medicare PIN