Provider Demographics
NPI:1225297211
Name:YANG, XIJIE (DDS)
Entity Type:Individual
Prefix:MRS
First Name:XIJIE
Middle Name:
Last Name:YANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:CECILIA
Other - Middle Name:XIJIE
Other - Last Name:YANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:9980 PLACER ST APT B
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4191
Mailing Address - Country:US
Mailing Address - Phone:909-989-8049
Mailing Address - Fax:
Practice Address - Street 1:9595 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-2424
Practice Address - Country:US
Practice Address - Phone:909-624-9087
Practice Address - Fax:909-621-7547
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56991122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist