Provider Demographics
NPI:1053295493
Name:DAI, YANSONG
Entity type:Individual
Prefix:
First Name:YANSONG
Middle Name:
Last Name:DAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 NEW HAMPSHIRE AVE NW APT 714
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-6580
Mailing Address - Country:US
Mailing Address - Phone:646-204-1216
Mailing Address - Fax:
Practice Address - Street 1:8885 CENTRE PARK DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2199
Practice Address - Country:US
Practice Address - Phone:646-204-1216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02502171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist