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General NPI Number Information
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NPI Number | 1013611474
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Entity Type | Individual
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Provider Name | SUHYUN YANG DDS
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Gender | Female
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Dates
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Enumeration Date | 03/29/2023
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 3565 LANGSTON BLVD # S3B
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City | ARLINGTON
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State | VA
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Zip | 22207-3756
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Country | US
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Telephone | 571-447-5577
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Fax |
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Provider Business Mailing Address
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Address Line | 5457 SERVICEBERRY ST
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City | CENTREVILLE
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State | VA
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Zip | 20120-5011
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Country | US
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Telephone | 703-627-8589
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401419071
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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