Provider Demographics
NPI:1053509711
Name:TSAI, YA-TING (DMD)
Entity Type:Individual
Prefix:
First Name:YA-TING
Middle Name:
Last Name:TSAI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11660 CHURCH ST
Mailing Address - Street 2:APT 295
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-8917
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1630 E 4TH ST
Practice Address - Street 2:M
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-2604
Practice Address - Country:US
Practice Address - Phone:909-980-3914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2008-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA563991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice