Provider Demographics
NPI:1134153174
Name:YIN, XUAN (DMD)
Entity type:Individual
Prefix:DR
First Name:XUAN
Middle Name:
Last Name:YIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8020 W CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-2827
Mailing Address - Country:US
Mailing Address - Phone:610-789-9968
Mailing Address - Fax:610-789-9979
Practice Address - Street 1:8020 W CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-2827
Practice Address - Country:US
Practice Address - Phone:610-789-9968
Practice Address - Fax:610-789-9979
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-030578-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist