Provider Demographics
NPI:1538357553
Name:YANG, PEGGY HP (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:PEGGY
Middle Name:HP
Last Name:YANG
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 W 23RD ST
Mailing Address - Street 2:APT #N12J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-1011
Mailing Address - Country:US
Mailing Address - Phone:917-207-4986
Mailing Address - Fax:
Practice Address - Street 1:555 W 23RD ST
Practice Address - Street 2:APT #N12J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-1011
Practice Address - Country:US
Practice Address - Phone:917-207-4986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI023377001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics