Provider Demographics
NPI:1710571450
Name:YEN PHAN DDS, INC
Entity Type:Organization
Organization Name:YEN PHAN DDS, INC
Other - Org Name:YP CENTER FOR TMJ, OROFACIAL PAIN, HEADACHES AND SLEEP MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YEN
Authorized Official - Middle Name:BICH
Authorized Official - Last Name:PHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:657-313-5571
Mailing Address - Street 1:9100 WALKER ST
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-3128
Mailing Address - Country:US
Mailing Address - Phone:657-313-5571
Mailing Address - Fax:714-699-1975
Practice Address - Street 1:9100 WALKER ST
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-3128
Practice Address - Country:US
Practice Address - Phone:714-249-0558
Practice Address - Fax:714-699-1975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-23
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X2210XDental ProvidersDentistOrofacial PainGroup - Single Specialty