TAE YOUN DDS MD PLLC (NPI# 1679197016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679197016 |
| Entity Type | Organization |
| Organization Name | TAE YOUN DDS MD PLLC |
| Practice Address |
15808 Mill Creek Blvd Ste 202 Mill Creek WA 98012-1500 |
| Practice Telephone | 4253184789 |
| Mailing Telephone | 4253184789 |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2020-06-02 |
| Authorized Official Name | TAE LIM YOUN (ORAL SURGEON) |
| Authorized Official Telephone | 4253184789 |
| Authorized Official Credential | DDS, MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Mill Creek Oral and Implant Surgery | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | TAE YOUN DDS MD PLLC | 12307 31st Ave Se, Everett, WA 98208-6161 |
| Street Address |
15808 MILL CREEK BLVD STE 202 |
| City | MILL CREEK |
| State | WA |
| Zip Code | 98012-1500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811502032 | Malia Van-frances Chase | Behavioral Analyst | 18311 Bothel-everett Hwy, Suite 260, Bothell, Wa, WA 98012 | 2020-09-14 |
| 1154951804 | Thea E Byrne | Physical Therapist | 6030 Bothell Everett Hwy, #140, Mill Creek, WA 98012 | 2020-01-22 |
| 1861975526 | Jenifer Rae Denormandie | Pharmacist | 14529 North Creek Drive Apt B210, Mill Creek, WA 98012 | 2018-09-10 |
| 1780161760 | Azadeh Fariba | Naturopath | 15411 40th Dr Se, Bothell, WA 98012 | 2018-07-23 |
| 1720572902 | Rickey Lee Mcgregor | Counselor | 16300 Mill Creek Blvd, Suite 204, Mill Creek, WA 98012 | 2018-06-20 |
| 1306349865 | Rudi Lauren Romaine | Behavioral Analyst | 18311 Bothell-everett Hwy, Suite 260, Bothell, WA 98012 | 2018-03-12 |
| 1164961025 | Wickler Behavioral Consulting | Behavioral Analyst | 632 182nd Street Se, Bothell, WA 98012 | 2017-02-13 |
| 1588026413 | Nathan Earl Crawford | Massage Therapist | 18930 Bothell Everett Hwy, D302, Bothell, WA 98012 | 2016-03-21 |
| 1144618083 | Jocelyn Enabulele | Counselor | 19105 Waxen Road, Bothell, WA 98012 | 2014-12-30 |
| 1124426846 | Teeth R Us | Dentist | 1908 201 Pl Se Suite #201, Bothell, WA 98012 | 2014-12-11 |
| Find all providers in zip 98012 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619657 | Washington Jaw and Facial Surgery Pllc | Dentist | 451 Duvall Ave Ne Ste 100, Renton, WA 98059-4675 | 2020-11-02 |
| 1952909145 | Calley Christie Dmd Pllc | Dentist | 275 Sw 160th St Ste 115, Burien, WA 98166-3003 | 2020-10-11 |
| 1417416728 | Sam Wise | Dentist | 1538 11th Ave Lowr Columbia, Longview, WA 98632 | 2019-03-16 |
| 1740744374 | Thompson Ferguson Schrack Pllc | Dentist | 7604 Ne 5th Ave Ste 114, Vancouver, WA 98665-8200 | 2019-01-28 |
| 1053875096 | John K Tidwell Dds and Elizabeth A Kutcipal Dds Pllc | Dentist | 1801 Nw Market St Ste 108, Seattle, WA 98107-3909 | 2019-01-23 |
| 1255803904 | Edwards, Johnson, Johnson & Johnson D.d.s., P.l.l.c. | Dentist | 601 S Carr Rd Ste 300, Renton, WA 98055-5840 | 2018-12-19 |
| 1104396969 | Mark Stivers, Dds, Inc., P.s. | Dentist | 12728 19th Ave Se Ste 101, Everett, WA 98208-6526 | 2018-12-04 |
| 1144797499 | Washington Jaw and Facial Surgery Pllc | Dentist | 1370 116th Ave Ne Ste 101, Bellevue, WA 98004-3825 | 2018-10-25 |
| 1780151027 | Washington Jaw and Facial Surgery Pllc | Dentist | 2111 N Northgate Way Ste 105, Seattle, WA 98133-9018 | 2018-10-25 |
| 1043728827 | Lance D Keyes Dds | Dentist | 32650 State Route 20 Ste E106, Oak Harbor, WA 98277 | 2018-01-16 |
| Find all providers with the same taxonomy | ||||
| City | MILL CREEK |
| Zip Code | 98012 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.