Provider Demographics
NPI:1033691357
Name:YU, YA-HSIN (DDS, MS, DMD)
Entity type:Individual
Prefix:
First Name:YA-HSIN
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:DDS, MS, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11020 71ST RD STE 120
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4977
Mailing Address - Country:US
Mailing Address - Phone:718-544-8787
Mailing Address - Fax:
Practice Address - Street 1:11020 71ST RD STE 120
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4977
Practice Address - Country:US
Practice Address - Phone:718-544-8787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0616791223E0200X, 1223E0200X
PADS0430081223E0200X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist