Provider Demographics
NPI:1033695317
Name:YANG, XIAOFEN (RDH)
Entity Type:Individual
Prefix:
First Name:XIAOFEN
Middle Name:
Last Name:YANG
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 E 149TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-5589
Mailing Address - Country:US
Mailing Address - Phone:718-579-4657
Mailing Address - Fax:718-579-4744
Practice Address - Street 1:234 E 149TH ST
Practice Address - Street 2:DENTAL
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5589
Practice Address - Country:US
Practice Address - Phone:718-579-4657
Practice Address - Fax:718-579-4744
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025022-1124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY025022-1OtherNYS LICENSE NUMBER