Provider Demographics
NPI:1205162948
Name:YING WU D.D.S.,INC.
Entity type:Organization
Organization Name:YING WU D.D.S.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YING
Authorized Official - Middle Name:
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-904-1150
Mailing Address - Street 1:12651 LAKEWOOD BLVD
Mailing Address - Street 2:101
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-4561
Mailing Address - Country:US
Mailing Address - Phone:562-904-1150
Mailing Address - Fax:562-904-1160
Practice Address - Street 1:12651 LAKEWOOD BLVD
Practice Address - Street 2:101
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-4561
Practice Address - Country:US
Practice Address - Phone:562-904-1150
Practice Address - Fax:562-904-1160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-01
Last Update Date:2009-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45543122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty