Provider Demographics
NPI:1225417611
Name:KLAUS M. YI, D.D.S, INC.
Entity type:Organization
Organization Name:KLAUS M. YI, D.D.S, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MAGANER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:YI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-324-2939
Mailing Address - Street 1:34530 BOB HOPE DR
Mailing Address - Street 2:B
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:34530 BOB HOPE DR
Practice Address - Street 2:B
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-1727
Practice Address - Country:US
Practice Address - Phone:760-324-2939
Practice Address - Fax:760-324-3130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-19
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA510041223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty