Provider Demographics
NPI:1902960586
Name:YAO, KOCHEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:KOCHEN
Middle Name:
Last Name:YAO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6268 MONTROSE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2772
Mailing Address - Country:US
Mailing Address - Phone:301-816-0670
Mailing Address - Fax:240-290-0010
Practice Address - Street 1:6268 MONTROSE RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2772
Practice Address - Country:US
Practice Address - Phone:301-816-0670
Practice Address - Fax:240-290-0010
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD108711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice