Healthcare Provider Details

I. General information

NPI: 1194841304
Provider Name (Legal Business Name): JEANNE CHI-MEI YANG D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 09/10/2026
Certification Date: 09/09/2026
Deactivation Date: 08/27/2026
Reactivation Date: 09/01/2026

III. Provider practice location address

3018 NY -417
OLEAN NY
14760
US

IV. Provider business mailing address

3018 NY- 417
OLEAN NY
14760
US

V. Phone/Fax

Practice location:
  • Phone: 716-379-6279
  • Fax:
Mailing address:
  • Phone: 716-828-6023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS037778
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number058327
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: