Provider Demographics
NPI:1962816785
Name:YANG, LINDA (DMD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:YANG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1569 FALL RIVER DR
Mailing Address - Street 2:STE 193
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9059
Mailing Address - Country:US
Mailing Address - Phone:970-669-4433
Mailing Address - Fax:
Practice Address - Street 1:1569 FALL RIVER DR
Practice Address - Street 2:STE 193
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-9059
Practice Address - Country:US
Practice Address - Phone:970-669-4433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20602122300000X
CODN00202983122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist