MEDICARE: DR. MY YANG DDS

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	390200000X	Student in an Organized Health Care Education/Training Program
2	122300000X	Dentist	019.031514	IL

General Provider Information

NPI Number	:	1629439237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MY YANG DDS

Provider Business Mailing Address
First Line	:	834 S ARLINGTON HEIGHTS RD
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-3667
Country	:	US
Telephone Number	:	847-439-2223
Fax Number	:

Provider Business Practice Location Address
First Line	:	834 S ARLINGTON HEIGHTS RD
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-3667
Country	:	US
Telephone Number	:	847-439-2223
Fax Number	:

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

Provider Enumeration Date	:	03/09/2016
Last Update Date	:	10/27/2022

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Directions to “ DR. MY YANG DDS” Practice Location

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