Provider Demographics
NPI:1750912333
Name:WENDY YANG DDS MS PC
Entity type:Organization
Organization Name:WENDY YANG DDS MS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-609-7087
Mailing Address - Street 1:12650 SABRE SPRINGS PKWY STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-4114
Mailing Address - Country:US
Mailing Address - Phone:415-609-7087
Mailing Address - Fax:
Practice Address - Street 1:12650 SABRE SPRINGS PKWY STE 205
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-4114
Practice Address - Country:US
Practice Address - Phone:415-609-7087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-31
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA62527OtherDENTIST