Basic Information
Provider Information
NPI: 1447794656
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YANG
FirstName: CHIN-HUA
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential: DDS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 E NEWTON ST
Address2: G217
City: BOSTON
State: MA
PostalCode: 021182308
CountryCode: US
TelephoneNumber: 6176384750
FaxNumber:  
Practice Location
Address1: 100 E NEWTON ST
Address2: G217
City: BOSTON
State: MA
PostalCode: 021182308
CountryCode: US
TelephoneNumber: 6176384750
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/06/2016
LastUpdateDate: 12/06/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000XBB1832268PCY23MAY Dental ProvidersDentist 

No ID Information.


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