Provider Demographics
NPI:1245690445
Name:SEAN YAR DDS INC
Entity type:Organization
Organization Name:SEAN YAR DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-310-3712
Mailing Address - Street 1:PO BOX 27847
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92809-0128
Mailing Address - Country:US
Mailing Address - Phone:949-310-3712
Mailing Address - Fax:
Practice Address - Street 1:781 S WEIR CANYON RD STE 193
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92808-1965
Practice Address - Country:US
Practice Address - Phone:951-682-5777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-01
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54397332B00000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty