Provider Demographics
NPI:1184762692
Name:YU, JUDY (DMD)
Entity type:Individual
Prefix:DR
First Name:JUDY
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8567C FORT SMALLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-2631
Mailing Address - Country:US
Mailing Address - Phone:410-360-0440
Mailing Address - Fax:410-360-2359
Practice Address - Street 1:8567C FORT SMALLWOOD RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-2631
Practice Address - Country:US
Practice Address - Phone:410-360-0440
Practice Address - Fax:410-360-2359
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD126611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice