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General NPI Number Information
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NPI Number | 1942870183
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Entity Type | Individual
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Provider Name | JING IRIS YANG DMD
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Gender | Female
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Dates
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Enumeration Date | 06/29/2021
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 800 NE TENNEY RD STE B201
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City | VANCOUVER
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State | WA
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Zip | 98685-2831
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Country | US
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Telephone | 360-262-4509
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Fax |
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Provider Business Mailing Address
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Address Line | 8954 NE COLONNADE DR
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City | HILLSBORO
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State | OR
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Zip | 97124-7782
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Country | US
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Telephone | 781-864-0247
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DE61548777
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | D11909
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License Number State | OR
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