Individual provider Active NPI

Sireen Yang, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lagrange, IN
National Provider Identifier
1396316824
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
12013220A Issued in IN
Practice address
612 S Detroit St
Lagrange, IN 46761-2314
Phone
(260) 463-2111
NPI assigned
Jul 6, 2021
Last updated
Jun 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 12013220A IN Primary

Addresses

Primary practice location

612 S Detroit St
Lagrange, IN 46761-2314

Mailing address

11722 Allisonville Road
Ste 103 #394
Fishers, IN 46038

Other practice location 1

907 Lincolnway S
Ligonier, IN 46767-1707
Phone (260) 800-4044

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

LicenseStateTypeSpecialty
12013220AINMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
GB Fishers Orthodontics and Dentofacial Orthopedics PastSince Jul 1, 2021 Accepting new patients
Orthodontic Partners of Indiana, LLC Orthodontics and Dentofacial Orthopedics PastSince Jul 1, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1396316824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11722 ALLISONVILLE ROAD",
            "address_2": "STE 103 #394",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "46038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 S DETROIT ST",
            "city": "LAGRANGE",
            "state": "IN",
            "postal_code": "467612314",
            "telephone_number": "260-463-2111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "907 Lincolnway S",
            "address_purpose": "LOCATION",
            "city": "Ligonier",
            "state": "IN",
            "postal_code": "467671707",
            "country_code": "US",
            "telephone_number": "260-800-4044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANG",
        "first_name": "SIREEN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IN",
            "license": "12013220A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.