Provider Demographics
NPI:1215726864
Name:YURIY UDOD, DMD, PLLC
Entity type:Organization
Organization Name:YURIY UDOD, DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:YURIY
Authorized Official - Middle Name:
Authorized Official - Last Name:UDOD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:206-887-3623
Mailing Address - Street 1:6316 2ND STREET CT E
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98424-2403
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:350 S 38TH CT STE 225
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5775
Practice Address - Country:US
Practice Address - Phone:206-887-3623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental