Provider Demographics
NPI:1588745319
Name:YANG, STEPHEN SHUN YAO (DDS)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:SHUN YAO
Last Name:YANG
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 1:25030 ALESSANDRO BLVD
Mailing Address - Street 2:#D
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-4383
Mailing Address - Country:US
Mailing Address - Phone:951-924-0993
Mailing Address - Fax:951-247-9693
Practice Address - Street 1:25030 ALESSANDRO BLVD
Practice Address - Street 2:#D
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-4383
Practice Address - Country:US
Practice Address - Phone:951-924-0993
Practice Address - Fax:951-247-9693
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA314291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice