Provider Demographics
NPI:1396489324
Name:YANG, OLIVIA (DDS)
Entity type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:
Last Name:YANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 DIGITAL DR UNIT 408
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-4576
Mailing Address - Country:US
Mailing Address - Phone:617-335-1125
Mailing Address - Fax:
Practice Address - Street 1:8 FLAGSTONE DR UNIT C
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051-4912
Practice Address - Country:US
Practice Address - Phone:603-821-9290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-26
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04737122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist