Provider Demographics
NPI:1689960296
Name:NAM DANG DENTAL CORPORATION
Entity Type:Organization
Organization Name:NAM DANG DENTAL CORPORATION
Other - Org Name:YORBA LINDA SMILES DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:DANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-854-9920
Mailing Address - Street 1:2860 MICHELLE FL 2
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-1008
Mailing Address - Country:US
Mailing Address - Phone:714-368-2077
Mailing Address - Fax:714-368-2092
Practice Address - Street 1:16691 YORBA LINDA BLVD
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-2046
Practice Address - Country:US
Practice Address - Phone:714-854-9920
Practice Address - Fax:714-854-9915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty