Provider Demographics
NPI:1437172251
Name:YANG, JANE (DDS)
Entity Type:Individual
Prefix:
First Name:JANE
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 1:53 ELIZABETH ST
Mailing Address - Street 2:FLOOR 2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4617
Mailing Address - Country:US
Mailing Address - Phone:212-219-8182
Mailing Address - Fax:212-219-2685
Practice Address - Street 1:53 ELIZABETH ST
Practice Address - Street 2:FLOOR 2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4617
Practice Address - Country:US
Practice Address - Phone:212-219-8182
Practice Address - Fax:212-219-2685
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0484631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY014084OtherDORAL DENTAL
NYC1836OtherHEALTHPLEX
NY01981617Medicaid