Provider Demographics
NPI:1104169598
Name:YAP, ADWEN P (DDS)
Entity type:Individual
Prefix:DR
First Name:ADWEN
Middle Name:P
Last Name:YAP
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11481 HEACOCK ST
Mailing Address - Street 2:SUITE 160
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-7906
Mailing Address - Country:US
Mailing Address - Phone:951-242-5470
Mailing Address - Fax:951-242-5470
Practice Address - Street 1:11481 HEACOCK ST
Practice Address - Street 2:SUITE 160
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-7906
Practice Address - Country:US
Practice Address - Phone:951-242-5470
Practice Address - Fax:951-242-5470
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA373091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice