Provider Demographics
NPI:1689723926
Name:YANN, BORIN MAK (DDS)
Entity Type:Individual
Prefix:
First Name:BORIN
Middle Name:MAK
Last Name:YANN
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 1:6428 LANDSDOWNE CENTRE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-5003
Mailing Address - Country:US
Mailing Address - Phone:703-550-2940
Mailing Address - Fax:703-550-2943
Practice Address - Street 1:6428 LANDSDOWNE CENTRE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22315-5003
Practice Address - Country:US
Practice Address - Phone:703-550-2940
Practice Address - Fax:703-550-2943
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410442122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist