Individual provider Active NPI

Chihwen Alec Yen, D.M.D.

  • Periodontics
  • Clinton, MD
National Provider Identifier
1417000712
Registry record updated Sep 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
12725 Issued in MD
Practice address
9131 Piscataway Rd
Suite 720
Clinton, MD 20735-2508
Phone
(301) 868-7716
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 12725 MD Primary

Addresses

Primary practice location

9131 Piscataway Rd
Suite 720
Clinton, MD 20735-2508

Mailing address

7903 Orion Cir
Unit 106
Laurel, MD 20724-3101
Phone (617) 416-1536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jul 10, 2015 through Jul 10, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253836800000",
    "number": "1417000712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7903 ORION CIR",
            "address_2": "UNIT 106",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207243101",
            "telephone_number": "617-416-1536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9131 PISCATAWAY RD",
            "address_2": "SUITE 720",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207352508",
            "telephone_number": "301-868-7716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEN",
        "first_name": "CHIHWEN",
        "middle_name": "ALEC",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2009-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MD",
            "license": "12725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

Verify at the official NPI Registry.