Provider Demographics
NPI:1124352380
Name:YOON, TAE RIM (DMD)
Entity type:Individual
Prefix:MR
First Name:TAE RIM
Middle Name:
Last Name:YOON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20806 BOTHELL EVERETT HIGHWAY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021
Mailing Address - Country:US
Mailing Address - Phone:425-286-2078
Mailing Address - Fax:425-408-1659
Practice Address - Street 1:20806 BOTHELL EVERETT HIGHWAY
Practice Address - Street 2:SUITE 107
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021
Practice Address - Country:US
Practice Address - Phone:425-286-2078
Practice Address - Fax:425-408-1659
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-21
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE601562091223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry