Provider Demographics
NPI:1376755629
Name:YAO, ERIC SHIH-CHANG (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:SHIH-CHANG
Last Name:YAO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:ERIC
Other - Middle Name:
Other - Last Name:YAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1515 N 200TH ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-3330
Mailing Address - Country:US
Mailing Address - Phone:206-546-1611
Mailing Address - Fax:206-546-2804
Practice Address - Street 1:1515 N 200TH ST
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-3330
Practice Address - Country:US
Practice Address - Phone:206-546-1611
Practice Address - Fax:206-546-2804
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA82101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice