Provider Demographics
NPI:1508090838
Name:DAVID K I YEE DDS, LLC
Entity Type:Organization
Organization Name:DAVID K I YEE DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SINGLE OWNER MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:K I
Authorized Official - Last Name:YEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-532-7874
Mailing Address - Street 1:1060 YOUNG ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1609
Mailing Address - Country:US
Mailing Address - Phone:808-532-7874
Mailing Address - Fax:
Practice Address - Street 1:1060 YOUNG ST
Practice Address - Street 2:SUITE 310
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1609
Practice Address - Country:US
Practice Address - Phone:808-532-7874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-1684261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI066230-02Medicaid
HIDT-1684OtherHAWAII LICENSE
HI8661-1OtherHMSA