NPIMap

Organization Active NPI

Jerry Yang DDS Inc.

  • Dentist
  • Fremont, CA
National Provider Identifier
1639826951
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
JERRY YANG DDS INC.
Practice address
4529 Mattos Dr
Fremont, CA 94536-6736
Phone
(510) 797-2611
Fax
(510) 797-1543
NPI assigned
Mar 7, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Authorized official

Name
Dr. Jerry Yang, DDSNPI 1164569372
Title
President
Phone
(510) 825-4386

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

4529 Mattos Dr
Fremont, CA 94536-6736

Mailing address

4529 Mattos Dr
Fremont, CA 94536-6736
Phone (510) 797-2611

National Provider Directory

National Provider Directory

Locations

4529 Mattos Dr
Fremont, CA 94536
Phone (510) 797-2611

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646611200000",
    "number": "1639826951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4529 MATTOS DR",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945366736",
            "telephone_number": "510-797-2611",
            "fax_number": "510-797-1543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4529 MATTOS DR",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945366736",
            "telephone_number": "510-797-2611",
            "fax_number": "510-797-1543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY YANG DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-825-4386",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

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