Provider Demographics
NPI:1861659070
Name:YI, STEPHANIE SANGAH (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:SANGAH
Last Name:YI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 S 324TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8500
Mailing Address - Country:US
Mailing Address - Phone:253-815-0093
Mailing Address - Fax:253-815-9823
Practice Address - Street 1:1717 S 324TH ST STE A
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8500
Practice Address - Country:US
Practice Address - Phone:253-815-0093
Practice Address - Fax:253-815-9823
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00011050122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist