Provider Demographics
NPI:1902996267
Name:YI, AMANDA YEUN-HEE (DMD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:YEUN-HEE
Last Name:YI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11725 LEE HWY
Mailing Address - Street 2:SUITE A23
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-8800
Mailing Address - Country:US
Mailing Address - Phone:703-293-6300
Mailing Address - Fax:703-293-6309
Practice Address - Street 1:11725 LEE HWY
Practice Address - Street 2:SUITE A23
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-8800
Practice Address - Country:US
Practice Address - Phone:703-293-6300
Practice Address - Fax:703-293-6309
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014102741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice