Provider Demographics
NPI:1902829435
Name:YU, MAZIE (DDS)
Entity Type:Individual
Prefix:
First Name:MAZIE
Middle Name:
Last Name:YU
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 1:4935 LAKEMONT BLVD SE
Mailing Address - Street 2:SUITE B-3
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-7800
Mailing Address - Country:US
Mailing Address - Phone:425-746-2101
Mailing Address - Fax:425-746-2750
Practice Address - Street 1:4935 LAKEMONT BLVD SE
Practice Address - Street 2:SUITE B-3
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-7800
Practice Address - Country:US
Practice Address - Phone:425-746-2101
Practice Address - Fax:425-746-2750
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA80131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice