Provider Demographics
NPI:1760137194
Name:YANG QIU DDS PLLC
Entity Type:Organization
Organization Name:YANG QIU DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YANG
Authorized Official - Middle Name:
Authorized Official - Last Name:QIU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-440-6603
Mailing Address - Street 1:3808 UNION ST STE 4C
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5670
Mailing Address - Country:US
Mailing Address - Phone:718-440-6603
Mailing Address - Fax:
Practice Address - Street 1:3808 UNION ST STE 4C
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5670
Practice Address - Country:US
Practice Address - Phone:718-440-6603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty