Sophia Rong Yan, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

109679 Issued in CA

Practice address

675 Mariners Island Blvd Ste 110
San Mateo, CA 94404-1040

Phone

(650) 577-1988

NPI assigned

Dec 1, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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.

• Shirin Shahinfar Imani DDS Inc

  • General Practice Dentistry
  • San Mateo, CA
  • NPI 1154329084
  NPD (past)

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

{
    "created_epoch": "1701388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1235905142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 20TH AVE UNIT D",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941223432",
            "telephone_number": "908-255-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 MARINERS ISLAND BLVD STE 110",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944041040",
            "telephone_number": "650-577-1988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAN",
        "first_name": "SOPHIA",
        "middle_name": "RONG",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-01",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "109679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bo Xu, P.A.-C
• Frances Xu, MD
• Xuyu Zhang, DDS, Inc
• Neha Yadav, DDS
• Bonipal Yadegar
• Magdalena Yanez, MFTI
• Dan Yang, M.D.
• Huaiyu Yang, MD
• Jenny Sufei Yang, M.D.
• Kimberly J. Yang, MD

• Dentist in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.