Individual provider Active NPI

Manliu Yang, D.D.S.

  • Endodontics
  • Frederick, MD
National Provider Identifier
1437682283
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
17506 Issued in MD
Practice address
85 Thomas Johnson CT Ste a
Frederick, MD 21702-4331
Phone
(301) 663-0052
NPI assigned
Apr 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019031451 IL
Student in an Organized Health Care Education/Training Program 390200000X 390300000X
Endodontics 1223E0200X 17506 MD Primary

Addresses

Primary practice location

85 Thomas Johnson CT Ste a
Frederick, MD 21702-4331

Mailing address

85 Thomas Johnson CT Ste a
Frederick, MD 21702-4331

Other practice location 1

506 6th St
Brooklyn, NY 11215-3609
Phone (718) 780-3000

Other practice location 2

8541 S Cicero Ave
Chicago, IL 60652
Phone (312) 946-2093

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
019031451ILMDDentist
17506MDMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1491609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1437682283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 THOMAS JOHNSON CT STE A",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 THOMAS JOHNSON CT STE A",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024331",
            "telephone_number": "301-663-0052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 6th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112153609",
            "country_code": "US",
            "telephone_number": "718-780-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8541 S Cicero Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60652",
            "country_code": "US",
            "telephone_number": "312-946-2093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANG",
        "first_name": "MANLIU",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-08",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019031451",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": "390300000X",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MD",
            "license": "17506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.