Individual provider Active NPI

Mazie Yu, DDS

  • General Practice Dentistry
  • Bellevue, WA
National Provider Identifier
1902829435
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8013 Issued in WA
Practice address
4935 Lakemont Blvd SE
Suite B-3
Bellevue, WA 98006-7800
Phone
(425) 746-2101
Fax
(425) 746-2750
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8013 WA Primary

Addresses

Primary practice location

4935 Lakemont Blvd SE
Suite B-3
Bellevue, WA 98006-7800

Mailing address

4935 Lakemont Blvd SE
Suite B-3
Bellevue, WA 98006-7800
Phone (425) 746-2101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160513000311 WA Order and Referring Only - DentistPractitioner - Dentist 4587953633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8013WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dara Kim, DDS, PLLC General Practice PastSince Jul 3, 2022 Accepting new patients
Winston Lo DDS, PLLC PastSince May 8, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902829435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4935 LAKEMONT BLVD SE",
            "address_2": "SUITE B-3",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980067800",
            "telephone_number": "425-746-2101",
            "fax_number": "425-746-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4935 LAKEMONT BLVD SE",
            "address_2": "SUITE B-3",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980067800",
            "telephone_number": "425-746-2101",
            "fax_number": "425-746-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YU",
        "first_name": "MAZIE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "8013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.