Provider Demographics
NPI:1821182312
Name:YUILLE, KATRINA (DDS)
Entity type:Individual
Prefix:DR
First Name:KATRINA
Middle Name:
Last Name:YUILLE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KATRINA
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:625 S FAIR OAKS AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2663
Mailing Address - Country:US
Mailing Address - Phone:626-395-9588
Mailing Address - Fax:
Practice Address - Street 1:625 S FAIR OAKS AVE STE 230
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105
Practice Address - Country:US
Practice Address - Phone:626-395-9588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA549461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice