Provider Demographics
NPI:1811661390
Name:LAU, YUKTING (DDS)
Entity type:Individual
Prefix:
First Name:YUKTING
Middle Name:
Last Name:LAU
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 1:800 6TH ST NW APT 706
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3759
Mailing Address - Country:US
Mailing Address - Phone:202-361-9635
Mailing Address - Fax:
Practice Address - Street 1:25 NORTHRIDGE LN
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-3399
Practice Address - Country:US
Practice Address - Phone:540-464-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014176431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice