Provider Demographics
NPI:1841211075
Name:Y.M.WU DDS & C.H.LAN DDS PROF. CORP.
Entity Type:Organization
Organization Name:Y.M.WU DDS & C.H.LAN DDS PROF. CORP.
Other - Org Name:AGAPE DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YEMING
Authorized Official - Middle Name:
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-792-5551
Mailing Address - Street 1:4988 PASEO PADRE PKWY # 204
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-3412
Mailing Address - Country:US
Mailing Address - Phone:510-792-5551
Mailing Address - Fax:510-792-5570
Practice Address - Street 1:4988 PASEO PADRE PKWY # 204
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94555-3412
Practice Address - Country:US
Practice Address - Phone:510-792-5551
Practice Address - Fax:510-792-5570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA411851223G0001X
CA437441223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty