Provider Demographics
NPI:1962539403
Name:YANG, LAN II (DMD)
Entity type:Individual
Prefix:
First Name:LAN
Middle Name:
Last Name:YANG
Suffix:II
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1045 E VALLEY BLVD
Mailing Address - Street 2:#A209
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-3661
Mailing Address - Country:US
Mailing Address - Phone:626-757-3870
Mailing Address - Fax:626-572-7238
Practice Address - Street 1:9193 SIERRA AVE STE D
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-4776
Practice Address - Country:US
Practice Address - Phone:909-822-2226
Practice Address - Fax:909-822-2384
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA532991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice