Provider Demographics
NPI:1013401512
Name:YANG, RAYMOND (DMD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:YANG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 N MIDLAND DR STE 5C
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-5592
Mailing Address - Country:US
Mailing Address - Phone:432-218-8198
Mailing Address - Fax:432-218-8198
Practice Address - Street 1:2215 N MIDLAND DR STE 5C
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-5592
Practice Address - Country:US
Practice Address - Phone:432-218-8198
Practice Address - Fax:432-218-8198
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34070122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist