Provider Demographics
NPI:1770017592
Name:YANG, BRIANNA YOUJIN (DMD)
Entity type:Individual
Prefix:
First Name:BRIANNA YOUJIN
Middle Name:
Last Name:YANG
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 1:3925 WALNUT ST
Mailing Address - Street 2:APT 917
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3624
Mailing Address - Country:US
Mailing Address - Phone:404-357-8068
Mailing Address - Fax:
Practice Address - Street 1:3925 WALNUT ST
Practice Address - Street 2:APT 917
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3624
Practice Address - Country:US
Practice Address - Phone:404-357-8068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0411491223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics