Provider Demographics
NPI:1225103211
Name:YANG, CHUNG WEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHUNG WEN
Middle Name:
Last Name:YANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16025 E GALE AVE
Mailing Address - Street 2:SUITE A8
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91745
Mailing Address - Country:US
Mailing Address - Phone:626-855-4667
Mailing Address - Fax:626-855-4666
Practice Address - Street 1:16025 E GALE AVE
Practice Address - Street 2:SUITE A8
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91745
Practice Address - Country:US
Practice Address - Phone:626-855-4667
Practice Address - Fax:626-855-4666
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31734122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist