Provider Demographics
NPI:1023251477
Name:AHN, YEJIN (DDS)
Entity type:Individual
Prefix:MRS
First Name:YEJIN
Middle Name:
Last Name:AHN
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 1:8031 W 3500 S
Mailing Address - Street 2:
Mailing Address - City:MAGNA
Mailing Address - State:UT
Mailing Address - Zip Code:84044-2218
Mailing Address - Country:US
Mailing Address - Phone:801-250-0668
Mailing Address - Fax:801-250-2865
Practice Address - Street 1:8031 W 3500 S
Practice Address - Street 2:
Practice Address - City:MAGNA
Practice Address - State:UT
Practice Address - Zip Code:84044-2218
Practice Address - Country:US
Practice Address - Phone:801-250-0668
Practice Address - Fax:801-250-2865
Is Sole Proprietor?:No
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7162882-9921122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist