Provider Demographics
NPI:1841494481
Name:YANG, KATHLEEN NAI-TAN (DDS)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:NAI-TAN
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 1:2901 E KATELLA AVE
Mailing Address - Street 2:STE F
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867
Mailing Address - Country:US
Mailing Address - Phone:714-538-0386
Mailing Address - Fax:714-639-9134
Practice Address - Street 1:2901 E KATELLA AVE
Practice Address - Street 2:# F
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867
Practice Address - Country:US
Practice Address - Phone:714-538-0386
Practice Address - Fax:714-639-9134
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30968122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist