Provider Demographics
NPI:1841472875
Name:TANG, YAT YEUNG (DDS)
Entity type:Individual
Prefix:DR
First Name:YAT
Middle Name:YEUNG
Last Name:TANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 S BROADWAY
Mailing Address - Street 2:STE E
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-8801
Mailing Address - Country:US
Mailing Address - Phone:805-925-3717
Mailing Address - Fax:
Practice Address - Street 1:1414 S MILLER
Practice Address - Street 2:STE. 1
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-6916
Practice Address - Country:US
Practice Address - Phone:805-349-8890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA565011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice