Organization Active NPI

David W. Yang, a Professional Corporation

  • Dentist
  • San Bernardino, CA
National Provider Identifier
1063533503
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D42901 Issued in CA
Legal business name
DAVID W. YANG, A PROFESSIONAL CORPORATION
Practice address
1643 E Highland Ave Ste B
San Bernardino, CA 92404-4678
Phone
(909) 885-3738
Fax
(909) 885-8238
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David W Yang, DDSNPI 1679643084
Title
President
Phone
(909) 885-3738

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D42901 CA Primary

Addresses

Primary practice location

1643 E Highland Ave Ste B
San Bernardino, CA 92404-4678

Mailing address

1643 E Highland Ave Ste B
San Bernardino, CA 92404-4678
Phone (909) 885-3738

Other identifiers 1

IdentifierTypeStateIssuer
G92068MedicaidCA

National Provider Directory

National Provider Directory

Locations

1643 E Highland Ave
Ste B
San Bernardino, CA 92404
Phone (909) 885-3738

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063533503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1643 E HIGHLAND AVE STE B",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044678",
            "telephone_number": "909-885-3738",
            "fax_number": "909-885-8238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1643 E HIGHLAND AVE STE B",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044678",
            "telephone_number": "909-885-3738",
            "fax_number": "909-885-8238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID W. YANG, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-885-3738",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "D42901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G92068",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.