Mira Yang, RDHAP

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

HAP954 Issued in CA

Practice address

10373 Gilliam Dr
Elk Grove, CA 95757-3512

Phone

(916) 502-7252

NPI assigned

Apr 16, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Tooth Fairies of California

  • Public Health or Welfare Agency
  • Elk Grove, CA
  • NPI 1093422040
  NPD Authorized official

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1083234363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10373 GILLIAM DR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957573512",
            "telephone_number": "916-502-7252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10373 GILLIAM DR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957573512",
            "telephone_number": "916-502-7252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "MIRA",
        "credential": "RDHAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-16",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "23678",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "HAP954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gao E Yang
• Heidi Yang
• Isabella Yang
• Katelynn Yang
• Kia Yang
• Nou Yang
• Pang Chang Yang
• Rosebertt Yang
• William Yang, MD
• Matthew Yarkpah

• Dental Hygienist in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Dental Hygienist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.