Provider Demographics
NPI:1891911459
Name:YEN, TING-WEY (DDS)
Entity type:Individual
Prefix:MR
First Name:TING-WEY
Middle Name:
Last Name:YEN
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 1:319 REDONDO AVE.
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814
Mailing Address - Country:US
Mailing Address - Phone:562-423-7878
Mailing Address - Fax:562-438-7393
Practice Address - Street 1:319 REDONDO AVE.
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90814
Practice Address - Country:US
Practice Address - Phone:562-423-7878
Practice Address - Fax:562-438-7393
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADM0340171223P0700X
CA340171223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU30323Medicare UPIN
CATYD34017Medicare ID - Type Unspecified