Provider Demographics
NPI:1093149643
Name:CHIANG, YI-AN (DDS)
Entity Type:Individual
Prefix:
First Name:YI-AN
Middle Name:
Last Name:CHIANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 RANCHO ARROYO PKWY
Mailing Address - Street 2:APT 82
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-2756
Mailing Address - Country:US
Mailing Address - Phone:919-265-9624
Mailing Address - Fax:
Practice Address - Street 1:7046 DUBLIN BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-3017
Practice Address - Country:US
Practice Address - Phone:919-265-9624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA629151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice