Provider Demographics
NPI:1194167254
Name:CUI, YAJUN (DMD)
Entity type:Individual
Prefix:
First Name:YAJUN
Middle Name:
Last Name:CUI
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 1:55 HILL RD
Mailing Address - Street 2:APT 601
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-4344
Mailing Address - Country:US
Mailing Address - Phone:216-367-9188
Mailing Address - Fax:
Practice Address - Street 1:1372 HANCOCK ST
Practice Address - Street 2:101
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5107
Practice Address - Country:US
Practice Address - Phone:617-472-3919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18562931223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics