Provider Demographics
NPI:1821198656
Name:DONALD M YAN D.D.S., INC
Entity Type:Organization
Organization Name:DONALD M YAN D.D.S., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:MANWAI
Authorized Official - Last Name:YAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-355-2391
Mailing Address - Street 1:55 W SIERRA MADRE BLVD
Mailing Address - Street 2:215
Mailing Address - City:SIERRA MADRE
Mailing Address - State:CA
Mailing Address - Zip Code:91024-2467
Mailing Address - Country:US
Mailing Address - Phone:626-355-2391
Mailing Address - Fax:626-355-5707
Practice Address - Street 1:55 W SIERRA MADRE BLVD
Practice Address - Street 2:215
Practice Address - City:SIERRA MADRE
Practice Address - State:CA
Practice Address - Zip Code:91024-2467
Practice Address - Country:US
Practice Address - Phone:626-355-2391
Practice Address - Fax:626-355-5707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA281141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty