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NPI Code Detail

MEDICARE: DR. YI YANG DDS

MEDICARE: DR. YI YANG DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist33558TX
21223X0400XOrthodontics and Dentofacial Orthopedics Dentistry33558TX

General Provider Information

NPI Number : 1437663036
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. YI YANG DDS
Provider Business Mailing Address
First Line : 4321 MANCHESTER AVE # 302
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63110-2137
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3600 FM 1488 RD STE 90
Second Line :
City : CONROE
State : TX
Zip : 77384-3818
Country : US
Telephone Number : 936-271-5440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2017
Last Update Date : 11/20/2017

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Directions to “ DR. YI YANG DDS” Practice Location

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