Provider Demographics
NPI:1528256542
Name:DEL MUNDO, MARITES YAP (DMD MS)
Entity type:Individual
Prefix:DR
First Name:MARITES
Middle Name:YAP
Last Name:DEL MUNDO
Suffix:
Gender:F
Credentials:DMD MS
Other - Prefix:DR
Other - First Name:MARITES
Other - Middle Name:ESTOQUE
Other - Last Name:YAP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD, MS
Mailing Address - Street 1:6950 NE CAMPUS WAY
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-5611
Mailing Address - Country:US
Mailing Address - Phone:503-952-2164
Mailing Address - Fax:503-526-4418
Practice Address - Street 1:133 DEXTER AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-5103
Practice Address - Country:US
Practice Address - Phone:206-324-5453
Practice Address - Fax:206-323-2872
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000108191223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics