Provider Demographics
NPI:1720185937
Name:STEVE W. YANG DDS, PA
Entity Type:Organization
Organization Name:STEVE W. YANG DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:WOO-SUK
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-633-1322
Mailing Address - Street 1:2290 STATESVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28147-9166
Mailing Address - Country:US
Mailing Address - Phone:704-633-1322
Mailing Address - Fax:704-633-2293
Practice Address - Street 1:2290 STATESVILLE BLVD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-9166
Practice Address - Country:US
Practice Address - Phone:704-633-1322
Practice Address - Fax:704-633-2293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC67381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89-90070Medicaid
NCU66309Medicare UPIN