Provider Demographics
NPI:1366541328
Name:JOHN C. LO JR DMD & KAREN YEE-LO DMD LLC
Entity type:Organization
Organization Name:JOHN C. LO JR DMD & KAREN YEE-LO DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:LO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:253-584-3333
Mailing Address - Street 1:7609 STEILACOOM BLVD SW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498
Mailing Address - Country:US
Mailing Address - Phone:253-584-3333
Mailing Address - Fax:253-589-2556
Practice Address - Street 1:7609 STEILACOOM BLVD SW
Practice Address - Street 2:SUITE 100
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98498
Practice Address - Country:US
Practice Address - Phone:253-584-3333
Practice Address - Fax:253-589-2556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE78001223G0001X
WADE77991223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty