Individual provider Active NPI

Maichou Yang, D.D.S.

  • General Practice Dentistry
  • Roseville, CA
National Provider Identifier
1053760587
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
100292 Issued in CA
Practice address
700 Sunrise Ave Ste E
Roseville, CA 95661-4561
Phone
(916) 773-1122
NPI assigned
Jun 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 100292 CA Primary

Addresses

Primary practice location

700 Sunrise Ave Ste E
Roseville, CA 95661-4561

Mailing address

700 Sunrise Ave Ste E
Roseville, CA 95661-4561
Phone (916) 773-1122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100292CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Shawn Kelly DDS Inc PastSince Mar 1, 2020 Accepting new patients
Kearbey Dental Group General Practice Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1053760587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SUNRISE AVE STE E",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614561",
            "telephone_number": "916-773-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SUNRISE AVE STE E",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614561",
            "telephone_number": "916-773-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "MAICHOU",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-06",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "100292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.