Provider Demographics
NPI:1932305679
Name:YEE, NANCY JEN (DDS)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JEN
Last Name:YEE
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 1:620 ARIZONA AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-1655
Mailing Address - Country:US
Mailing Address - Phone:310-395-7221
Mailing Address - Fax:310-237-5863
Practice Address - Street 1:620 ARIZONA AVE
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-1655
Practice Address - Country:US
Practice Address - Phone:310-395-7221
Practice Address - Fax:310-237-5863
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA322091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice