MEDICARE: ADWEN P. YAP DDS, INC

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
1	1223G0001X	General Practice Dentistry	37309	CA

General Provider Information

NPI Number	:	1447278189
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADWEN P. YAP DDS, INC

Provider Business Mailing Address
First Line	:	11481 HEACOCK ST
Second Line	:	SUITE 160
City	:	MORENO VALLEY
State	:	CA
Zip	:	92557-7906
Country	:	US
Telephone Number	:	951-242-5470
Fax Number	:	951-242-5470

Provider Business Practice Location Address
First Line	:	11481 HEACOCK ST
Second Line	:	SUITE 160
City	:	MORENO VALLEY
State	:	CA
Zip	:	92557-7906
Country	:	US
Telephone Number	:	951-242-5470
Fax Number	:	951-242-5470

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. ADWEN P. YAP
Credential	:	DDS
Telephone Number	:	951-242-5470

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	08/22/2020

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