Provider Demographics
NPI:1841577020
Name:TANAKA AND YANG DENTAL PARTNERSHIP
Entity Type:Organization
Organization Name:TANAKA AND YANG DENTAL PARTNERSHIP
Other - Org Name:LA PAZ DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAEZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-855-9525
Mailing Address - Street 1:25200 LA PAZ RD STE 109
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-5134
Mailing Address - Country:US
Mailing Address - Phone:949-855-9525
Mailing Address - Fax:949-707-3933
Practice Address - Street 1:25200 LA PAZ RD STE 109
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-5134
Practice Address - Country:US
Practice Address - Phone:949-855-9525
Practice Address - Fax:949-707-3933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31169122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty