Provider Demographics
NPI:1013907732
Name:SHARLENE H YUAN DDS PC
Entity type:Organization
Organization Name:SHARLENE H YUAN DDS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARLENE
Authorized Official - Middle Name:H
Authorized Official - Last Name:YUAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-398-1788
Mailing Address - Street 1:612 S 72ND ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4612
Mailing Address - Country:US
Mailing Address - Phone:402-398-1788
Mailing Address - Fax:402-398-1732
Practice Address - Street 1:612 S 72ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4612
Practice Address - Country:US
Practice Address - Phone:402-398-1788
Practice Address - Fax:402-398-1732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-25
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6035122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty