Provider Demographics
NPI:1265628051
Name:YANG, DONG-XIAO (MD)
Entity type:Individual
Prefix:
First Name:DONG-XIAO
Middle Name:
Last Name:YANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-2826
Mailing Address - Country:US
Mailing Address - Phone:617-521-6810
Mailing Address - Fax:617-521-6898
Practice Address - Street 1:145 SOUTH ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-2826
Practice Address - Country:US
Practice Address - Phone:617-521-6810
Practice Address - Fax:617-521-6898
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10028148208000000X
IA39136208000000X
MA255197208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics