Provider Demographics
NPI:1861665887
Name:NATHAN K. YANG, DDS, INC.
Entity Type:Organization
Organization Name:NATHAN K. YANG, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:650-255-2433
Mailing Address - Street 1:380 20TH AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-2221
Mailing Address - Country:US
Mailing Address - Phone:650-255-2433
Mailing Address - Fax:
Practice Address - Street 1:380 20TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-2221
Practice Address - Country:US
Practice Address - Phone:650-255-2433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty