Provider Demographics
NPI:1083504682
Name:YEUNG, KAM (DDS)
Entity type:Individual
Prefix:DR
First Name:KAM
Middle Name:
Last Name:YEUNG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12170 WAVELAND ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-5523
Mailing Address - Country:US
Mailing Address - Phone:571-338-0412
Mailing Address - Fax:
Practice Address - Street 1:14901 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HAYMARKET
Practice Address - State:VA
Practice Address - Zip Code:20169-2921
Practice Address - Country:US
Practice Address - Phone:703-753-7707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014194621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice