Provider Demographics
NPI:1194248732
Name:TANG, YAT TO (DDS, PHD)
Entity type:Individual
Prefix:DR
First Name:YAT
Middle Name:TO
Last Name:TANG
Suffix:
Gender:M
Credentials:DDS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1442 N 41ST ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68503-2120
Mailing Address - Country:US
Mailing Address - Phone:626-863-5724
Mailing Address - Fax:
Practice Address - Street 1:4000 EAST CAMPUS LOOP SOUTH
Practice Address - Street 2:UNL'S EAST CAMPUS - 40TH & HOLDREGE STREETS
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68583-0740
Practice Address - Country:US
Practice Address - Phone:402-472-1333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NENA122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist