Healthcare Provider Details

I. General information

NPI: 1821479965
Provider Name (Legal Business Name): YANG DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2015
Last Update Date: 06/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2482 MISSION ST
SAN FRANCISCO CA
94110-2415
US

IV. Provider business mailing address

2460 MISSION ST 215
SAN FRANCISCO CA
94110-2467
US

V. Phone/Fax

Practice location:
  • Phone: 415-285-9900
  • Fax: 415-285-7553
Mailing address:
  • Phone: 415-285-9900
  • Fax: 415-285-7553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number48409
License Number StateCA

VIII. Authorized Official

Name: HENRY YANG
Title or Position: CEO
Credential: DDS
Phone: 925-984-9885