# EL PASO VIVA DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902144330
- **Authorized official:** DR. CHUNKIL YI DDS (PRESIDENT)
- **Authorized official phone:** (915) 751-1007

## Contact information

- **Practice address:** 9584 DYER ST., SUITE B, EL PASO, TX 79924
- **Practice address phone:** (915) 751-1007
- **Practice address fax:** (915) 751-1002
- **Mailing address:** 9584 DYER ST, SUITE B, EL PASO, TX 79924-4768
- **Mailing address phone:** (915) 751-1007
- **Mailing address fax:** (915) 751-1002

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 25483 | TX | Yes |

## Other

- **Enumeration date:** 01/18/2013
- **Last updated:** 01/18/2013