MEDICARE: YEN DENTISTRY P.C.

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	1223G0001X	General Practice Dentistry	19373	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	D19373	OTHER	TX	BLUE CROSS BLUE SHIELD
2	1306074	OTHER	TX	UNITED CONCORDIA
3	B19373-01	OTHER	TX	DELTA DENTAL

General Provider Information

NPI Number	:	1962617993
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YEN DENTISTRY P.C.

Provider Business Mailing Address
First Line	:	1332 S PLANO RD
Second Line	:	STE 520
City	:	RICHARDSON
State	:	TX
Zip	:	75081-5956
Country	:	US
Telephone Number	:	972-669-8888
Fax Number	:	972-669-1981

Provider Business Practice Location Address
First Line	:	1332 S PLANO RD
Second Line	:	STE 520
City	:	RICHARDSON
State	:	TX
Zip	:	75081-5956
Country	:	US
Telephone Number	:	972-669-8888
Fax Number	:	972-669-1981

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. YEN THI NGOC TRAN
Credential	:	D.D.S.
Telephone Number	:	972-669-8888

Provider Enumeration Date	:	05/12/2007
Last Update Date	:	08/22/2020

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Directions to “YEN DENTISTRY P.C. ” Practice Location

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