Provider Demographics
NPI:1902507445
Name:JUHYONG YI DENTAL CORPORATION
Entity Type:Organization
Organization Name:JUHYONG YI DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEONG
Authorized Official - Middle Name:
Authorized Official - Last Name:OH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-964-2225
Mailing Address - Street 1:1045 W EL CAMINO REAL
Mailing Address - Street 2:SUITE B
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040
Mailing Address - Country:US
Mailing Address - Phone:650-964-2225
Mailing Address - Fax:650-964-2056
Practice Address - Street 1:1045 W EL CAMINO REAL
Practice Address - Street 2:SUITE B
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040
Practice Address - Country:US
Practice Address - Phone:650-964-2225
Practice Address - Fax:650-964-2056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center