Provider Demographics
NPI:1922625250
Name:YI, HAE JIN (DDS)
Entity Type:Individual
Prefix:
First Name:HAE JIN
Middle Name:
Last Name:YI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ESTHER
Other - Middle Name:
Other - Last Name:YI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1900 S PUGET DR STE 102
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-4404
Mailing Address - Country:US
Mailing Address - Phone:425-228-1521
Mailing Address - Fax:
Practice Address - Street 1:1900 S PUGET DR STE 102
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-4404
Practice Address - Country:US
Practice Address - Phone:425-228-1521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE61082993122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist