Yi, Mira
Yi, Mira is an sole proprietor health care provider with primary practice located at 321 Broad Ave Building F #5, Ridgefield NJ 07657-2346. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Yi, Mira can be contacted via phone (201) 313-2277.Contact Information
Primary practice address
321 Broad Ave Building F #5
Ridgefield NJ 07657-2346
Phone: (201) 313-2277
Fax: (201) 313-0377
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 22DJ02249800 | New Jersey |
Profile Details
| NPI number | 1083943492 |
|---|---|
| LBN Legal business name | Yi, Mira |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 14th, 2009 |
| Last updated | Dec 14th, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083943492 | NPPES |
| New York | MEDICAID | 02495687 |
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