Provider Demographics
NPI:1891947347
Name:ZHOU, YU YE (DDS)
Entity Type:Individual
Prefix:
First Name:YU
Middle Name:YE
Last Name:ZHOU
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 1:136-81 ROOSEVELT AVENUE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5560
Mailing Address - Country:US
Mailing Address - Phone:718-353-4777
Mailing Address - Fax:
Practice Address - Street 1:136-81 ROOSEVELT AVENUE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5560
Practice Address - Country:US
Practice Address - Phone:718-353-4777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP639531223G0001X
TX243681223G0001X
NY0554071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03377699Medicaid