Provider Demographics
NPI:1124200902
Name:YANG, GRACE KUI HEA (DDS)
Entity Type:Individual
Prefix:DR
First Name:GRACE KUI HEA
Middle Name:
Last Name:YANG
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 1:2228 17TH PL
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93215-3788
Mailing Address - Country:US
Mailing Address - Phone:408-315-7033
Mailing Address - Fax:
Practice Address - Street 1:601 HIGH ST. STE A
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-2969
Practice Address - Country:US
Practice Address - Phone:661-725-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2018-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54922122300000X
TX304931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist