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General NPI Number Information
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NPI Number | 1700044237
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Entity Type | Individual
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Provider Name | TONY YANG D.D.S., M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 04/25/2024
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Provider Practice Location Address
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Address Line | 1000 N OAK AVE
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City | MARSHFIELD
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State | WI
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Zip | 54449-5702
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Country | US
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Telephone | 715-387-0057
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Fax |
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Provider Business Mailing Address
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Address Line | 54 HEARST
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City | IRVINE
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State | CA
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Zip | 92620-4203
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Country | US
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Telephone | 949-892-9088
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 1002522-15
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | OMS84
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 054147
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A103339
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 74078
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License Number State | WI
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