Provider Demographics
NPI:1740217025
Name:LAI, YEN-CHENG (DMD)
Entity Type:Individual
Prefix:DR
First Name:YEN-CHENG
Middle Name:
Last Name:LAI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 SHADY SIDE DR
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-2145
Mailing Address - Country:US
Mailing Address - Phone:413-565-2512
Mailing Address - Fax:413-565-2512
Practice Address - Street 1:1178 PARKER ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01129-1030
Practice Address - Country:US
Practice Address - Phone:413-783-5787
Practice Address - Fax:413-783-4577
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA187121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice