Provider Demographics
NPI:1396838652
Name:MA, MICHAEL NING-YUANG (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:NING-YUANG
Last Name:MA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:NING-YUANG
Other - Middle Name:
Other - Last Name:MA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:711 W COLLEGE ST
Mailing Address - Street 2:SUITE 570
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-1163
Mailing Address - Country:US
Mailing Address - Phone:213-617-9151
Mailing Address - Fax:213-617-1428
Practice Address - Street 1:711 W COLLEGE ST
Practice Address - Street 2:SUITE 570
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-1163
Practice Address - Country:US
Practice Address - Phone:213-617-9151
Practice Address - Fax:213-617-1428
Is Sole Proprietor?:No
Enumeration Date:2006-10-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA289541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice