Provider Demographics
NPI:1114101938
Name:CHAN, EDWARD YAP (DDS, MS, BDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:YAP
Last Name:CHAN
Suffix:
Gender:M
Credentials:DDS, MS, BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:991 MONTAGUE EXPY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-6809
Mailing Address - Country:US
Mailing Address - Phone:408-263-2338
Mailing Address - Fax:
Practice Address - Street 1:991 MONTAGUE EXPY
Practice Address - Street 2:SUITE 106
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-6809
Practice Address - Country:US
Practice Address - Phone:408-263-2338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA376381223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics