Individual provider Active NPI

Mimi Fu Yang, D.D.S.

  • General Practice Dentistry
  • Brea, CA
National Provider Identifier
1871622290
Registry record updated Jul 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
52486 Issued in CA
Practice address
1770 E Lambert Rd
Suite 200
Brea, CA 92821-8005
Phone
(714) 255-9700
Fax
(714) 255-9097
NPI assigned
Mar 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 52486 CA Primary

Addresses

Primary practice location

1770 E Lambert Rd
Suite 200
Brea, CA 92821-8005

Mailing address

1770 E Lambert Rd
Suite 200
Brea, CA 92821-8005
Phone (714) 255-9700

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
52486CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342051200000",
    "number": "1871622290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 E LAMBERT RD",
            "address_2": "SUITE 200",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928218005",
            "telephone_number": "714-255-9700",
            "fax_number": "714-255-9097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 E LAMBERT RD",
            "address_2": "SUITE 200",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928218005",
            "telephone_number": "714-255-9700",
            "fax_number": "714-255-9097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "MIMI",
        "middle_name": "FU",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2012-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "52486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; 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.