Healthcare Provider Details

I. General information

NPI: 1518658541
Provider Name (Legal Business Name): BRENDA YEUNG DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2023
Last Update Date: 06/28/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4750 TOWNSHIP LINE RD
DREXEL HILL PA
19026-4221
US

IV. Provider business mailing address

4750 TOWNSHIP LINE RD
DREXEL HILL PA
19026-4221
US

V. Phone/Fax

Practice location:
  • Phone: 610-446-3990
  • Fax:
Mailing address:
  • Phone: 610-446-3990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDS045193
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: