Provider Demographics
NPI:1821606039
Name:YANG, PO-LIN (DDS)
Entity Type:Individual
Prefix:
First Name:PO-LIN
Middle Name:
Last Name:YANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4310 DUNLAVY ST APT 222
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-5294
Mailing Address - Country:US
Mailing Address - Phone:646-401-2327
Mailing Address - Fax:
Practice Address - Street 1:4500 WASHINGTON AVE STE 700
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-5478
Practice Address - Country:US
Practice Address - Phone:713-869-0334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX362381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice