Provider Demographics
NPI:1073908349
Name:TONY YANG D.D.S., M.D. CORP.
Entity Type:Organization
Organization Name:TONY YANG D.D.S., M.D. CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-393-5789
Mailing Address - Street 1:113 WATERWORKS WAY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3167
Mailing Address - Country:US
Mailing Address - Phone:949-393-5789
Mailing Address - Fax:949-777-6168
Practice Address - Street 1:113 WATERWORKS WAY
Practice Address - Street 2:SUITE 110
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3167
Practice Address - Country:US
Practice Address - Phone:949-393-5789
Practice Address - Fax:949-777-6168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-02
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOMS84261QS0112X, 261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery