Provider Demographics
NPI:1760220768
Name:YIN, ADDI A (BDS)
Entity type:Individual
Prefix:DR
First Name:ADDI
Middle Name:A
Last Name:YIN
Suffix:
Gender:F
Credentials:BDS
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:9927 NW 18TH RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-9250
Mailing Address - Country:US
Mailing Address - Phone:626-623-9379
Mailing Address - Fax:
Practice Address - Street 1:1395 CENTER DR RM D1-85
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3006
Practice Address - Country:US
Practice Address - Phone:352-273-6775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDRPM25061223X0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0008XDental ProvidersDentistOral and Maxillofacial Radiology