Active NPI
Michael Yang, D.D.S.
- General Practice Dentistry
- Tustin, CA
National Provider Identifier
1104954452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 46000
- Practice address
- 13112 Newport Ave Ste B
Tustin, CA 92780-3440 - Phone
- (714) 547-9194
- Fax
- (714) 486-2377
- NPI assigned
- Mar 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 46000 | CA | Primary |
Addresses
Primary practice location
13112 Newport Ave Ste B
Tustin, CA 92780-3440
Mailing address
13112 Newport Ave Ste B
Tustin, CA 92780-3440
Phone (714) 547-9194
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B46000-01 | Other | CA | HEALTHY FAMILY DELTA DENT |
| 95-4836920 | Other | CA | EMPLOYER I.D. NUMBER |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46000 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363651200000",
"number": "1104954452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13112 NEWPORT AVE STE B",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927803440",
"telephone_number": "714-547-9194",
"fax_number": "714-486-2377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13112 NEWPORT AVE STE B",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927803440",
"telephone_number": "714-547-9194",
"fax_number": "714-486-2377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YANG",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-01",
"last_updated": "2013-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "46000",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHY FAMILY DELTA DENT",
"identifier": "B46000-01",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPLOYER I.D. NUMBER",
"identifier": "95-4836920",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.