Provider Demographics
NPI:1649630948
Name:YOO-LEE YEA DDS PLLC
Entity type:Organization
Organization Name:YOO-LEE YEA DDS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:YOO-LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:YEA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MSD MPH
Authorized Official - Phone:206-852-7338
Mailing Address - Street 1:18807 BEARDSLEE BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-1712
Mailing Address - Country:US
Mailing Address - Phone:425-486-6300
Mailing Address - Fax:425-487-6498
Practice Address - Street 1:18807 BEARDSLEE BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-1712
Practice Address - Country:US
Practice Address - Phone:425-486-6300
Practice Address - Fax:425-487-6498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000099551223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty