Provider Demographics
NPI:1538227384
Name:YEN, DANIEL J (DDS)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:YEN
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 1:13630 MAPLE AVE
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3865
Mailing Address - Country:US
Mailing Address - Phone:718-358-1200
Mailing Address - Fax:718-358-1200
Practice Address - Street 1:136-30 MAPLE AVE
Practice Address - Street 2:SUITE 2E
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3865
Practice Address - Country:US
Practice Address - Phone:718-358-1200
Practice Address - Fax:718-358-1200
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034570122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered1223G0001XDental ProvidersDentistGeneral Practice