Provider Demographics
NPI:1487746475
Name:YEH, MITCHELL M (DMD)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:M
Last Name:YEH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:MING-CHI
Other - Middle Name:M
Other - Last Name:YEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:238 ERNSTON RD
Mailing Address - Street 2:
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-1947
Mailing Address - Country:US
Mailing Address - Phone:732-553-1313
Mailing Address - Fax:732-553-1301
Practice Address - Street 1:837 58TH ST FL 6
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3662
Practice Address - Country:US
Practice Address - Phone:718-686-9888
Practice Address - Fax:718-686-9889
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2008-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI230661223G0001X
NY05242411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice