Provider Demographics
NPI:1023106333
Name:YAO, EFFIE C (DDS)
Entity type:Individual
Prefix:DR
First Name:EFFIE
Middle Name:C
Last Name:YAO
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 1:4106 W LAKE MARY BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-2403
Mailing Address - Country:US
Mailing Address - Phone:407-333-0881
Mailing Address - Fax:407-333-2893
Practice Address - Street 1:4106 W LAKE MARY BLVD STE 230
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2403
Practice Address - Country:US
Practice Address - Phone:407-333-0881
Practice Address - Fax:407-333-2893
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN12228122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist