Provider Demographics
NPI:1073697710
Name:YEUNG, NICHOLAS MUN SIU (DDS)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:MUN SIU
Last Name:YEUNG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 EAST MAIN STREET
Mailing Address - Street 2:3
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801
Mailing Address - Country:US
Mailing Address - Phone:626-289-3755
Mailing Address - Fax:626-289-3756
Practice Address - Street 1:1212 EAST MAIN STREET
Practice Address - Street 2:3
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801
Practice Address - Country:US
Practice Address - Phone:626-289-3755
Practice Address - Fax:626-289-3756
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA418841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice