Healthcare Provider Details

I. General information

NPI: 1588670467
Provider Name (Legal Business Name): WILLIAM M. YAO D.D.S., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 DAY VALLEY RD
APTOS CA
95003-9538
US

IV. Provider business mailing address

1600 DAY VALLEY RD
APTOS CA
95003-9538
US

V. Phone/Fax

Practice location:
  • Phone: 831-662-3961
  • Fax:
Mailing address:
  • Phone: 831-662-3961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number54043
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: