Organization Active NPI

Tony Yang DDS MD PLLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Boulder, CO
National Provider Identifier
1073908349
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
License
OMS84 Issued in CA
Legal business name
TONY YANG DDS MD PLLC
Practice address
3400 Penrose PL Ste 106
Boulder, CO 80301-1809
Phone
(303) 604-9393
Fax
(303) 442-3878
NPI assigned
Apr 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Authorized official

Name
Tony Yang, M.D.NPI 1700044237
Title
MD
Phone
(949) 393-5789

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
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X OMS84 CA Primary

Addresses

Primary practice location

3400 Penrose PL Ste 106
Boulder, CO 80301-1809

Mailing address

3400 Penrose PL Ste 106
Boulder, CO 80301-1809
Phone (303) 604-9393

National Provider Directory

National Provider Directory

Locations

113 Waterworks Way
Ste 110
Irvine, CA 92618
Phone (949) 393-5789

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": "1427932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780272000000",
    "number": "1073908349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 PENROSE PL STE 106",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011809",
            "telephone_number": "303-604-9393",
            "fax_number": "303-442-3878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 PENROSE PL STE 106",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011809",
            "telephone_number": "303-604-9393",
            "fax_number": "303-442-3878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TONY YANG DDS MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-02",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "949-393-5789",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "OMS84",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; 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.