Provider Demographics
NPI:1699254177
Name:DANG, BINH YEN (DMD)
Entity type:Individual
Prefix:
First Name:BINH
Middle Name:YEN
Last Name:DANG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9432 HONEYSUCKLE AVE
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-1407
Mailing Address - Country:US
Mailing Address - Phone:714-548-8352
Mailing Address - Fax:
Practice Address - Street 1:14515 MOJAVE DR
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92394-6762
Practice Address - Country:US
Practice Address - Phone:760-241-8090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1025501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice