Provider Demographics
NPI:1841963121
Name:YAM, NATALIE (DDS, MMSC)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:YAM
Suffix:
Gender:F
Credentials:DDS, MMSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9136 71ST RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-6711
Mailing Address - Country:US
Mailing Address - Phone:646-470-2228
Mailing Address - Fax:
Practice Address - Street 1:678 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-1306
Practice Address - Country:US
Practice Address - Phone:631-587-5870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-31
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18591331223P0300X
NJ22DI030457001223P0300X
NY0639741223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics