Provider Demographics
NPI:1447278189
Name:ADWEN P. YAP DDS, INC
Entity type:Organization
Organization Name:ADWEN P. YAP DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ADWEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:YAP
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-242-5470
Mailing Address - Street 1:11481 HEACOCK ST
Mailing Address - Street 2:SUITE 160
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-7906
Mailing Address - Country:US
Mailing Address - Phone:951-242-5470
Mailing Address - Fax:951-242-5470
Practice Address - Street 1:11481 HEACOCK ST
Practice Address - Street 2:SUITE 160
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-7906
Practice Address - Country:US
Practice Address - Phone:951-242-5470
Practice Address - Fax:951-242-5470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA373091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty