Provider Demographics
NPI:1932325800
Name:LAN YANG D.D.S.INC
Entity Type:Organization
Organization Name:LAN YANG D.D.S.INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:II
Authorized Official - Credentials:DMD
Authorized Official - Phone:626-572-7238
Mailing Address - Street 1:1045 E VALLEY BLVD
Mailing Address - Street 2:#A209
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-3661
Mailing Address - Country:US
Mailing Address - Phone:626-572-7238
Mailing Address - Fax:626-572-7238
Practice Address - Street 1:1045 E VALLEY BLVD
Practice Address - Street 2:#A209
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3661
Practice Address - Country:US
Practice Address - Phone:626-572-7238
Practice Address - Fax:626-572-7238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA532991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========Medicare ID - Type UnspecifiedDENTAL OFFICE