Provider Demographics
NPI:1538254396
Name:NELSON T. YEN DDS, MS INC.
Entity type:Organization
Organization Name:NELSON T. YEN DDS, MS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYER
Authorized Official - Prefix:DR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:T
Authorized Official - Last Name:YEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-381-4699
Mailing Address - Street 1:130 LAGUNA RD STE B
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3650
Mailing Address - Country:US
Mailing Address - Phone:714-441-0436
Mailing Address - Fax:
Practice Address - Street 1:220 LAGUNA RD
Practice Address - Street 2:SUITE 3
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-2523
Practice Address - Country:US
Practice Address - Phone:714-441-0436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA292401223P0300X
CA462311223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty