Provider Demographics
NPI:1568026284
Name:HE, YI (DDS)
Entity type:Individual
Prefix:DR
First Name:YI
Middle Name:
Last Name:HE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:RICHARD
Other - Middle Name:
Other - Last Name:HE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1404 LAKE TAPPS PKWY SE STE A103
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-8156
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1404 LAKE TAPPS PKWY SE STE A103
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-8156
Practice Address - Country:US
Practice Address - Phone:253-341-4973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-29
Last Update Date:2020-08-12
Deactivation Date:2019-12-03
Deactivation Code:
Reactivation Date:2020-02-11
Provider Licenses
StateLicense IDTaxonomies
WADE610755911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice