Healthcare Provider Details

I. General information

NPI: 1700719259
Provider Name (Legal Business Name): PEI WEN YANG DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: IRENE YANG DMD

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15260 W MCDOWELL RD
GOODYEAR AZ
85395-2530
US

IV. Provider business mailing address

15260 W MCDOWELL RD
GOODYEAR AZ
85395-2530
US

V. Phone/Fax

Practice location:
  • Phone: 623-207-7838
  • Fax:
Mailing address:
  • Phone: 623-207-7838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberD012812
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD012812
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: