Provider Demographics
NPI:1093974842
Name:YEN, GREG MEI YOUNG (DDS, FAGD)
Entity Type:Individual
Prefix:DR
First Name:GREG
Middle Name:MEI YOUNG
Last Name:YEN
Suffix:
Gender:M
Credentials:DDS, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-3014
Mailing Address - Country:US
Mailing Address - Phone:516-599-3131
Mailing Address - Fax:516-887-0125
Practice Address - Street 1:50 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-3014
Practice Address - Country:US
Practice Address - Phone:516-599-3131
Practice Address - Fax:516-887-0125
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0349191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice