Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 0401413766 | VA |
NPI | 1245490564 |
---|---|
Provider Name | Dr. Jeanne C. Yang |
First Address | Fairfax, VA 22030-1806 |
Second Address | Fairfax, VA 22030-1806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2008 |
Last Update Date | 03/04/2013 |