MEDICARE: DANA YAO RDHAP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	64	CA

General Provider Information

NPI Number	:	1114134889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA YAO RDHAP

Provider Business Mailing Address
First Line	:	1555 CHERRY ST APT 3
Second Line	:
City	:	SAN CARLOS
State	:	CA
Zip	:	94070-3093
Country	:	US
Telephone Number	:	831-419-1296
Fax Number	:

Provider Business Practice Location Address
First Line	:	1555 CHERRY ST APT 3
Second Line	:
City	:	SAN CARLOS
State	:	CA
Zip	:	94070-3093
Country	:	US
Telephone Number	:	831-419-1296
Fax Number	:	866-281-6027

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	11/15/2010

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