Provider Demographics
NPI:1447453899
Name:YIP, DANA ANTHONY (DDS)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:ANTHONY
Last Name:YIP
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18676 WILLAMETTE DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-1718
Mailing Address - Country:US
Mailing Address - Phone:503-697-4746
Mailing Address - Fax:503-635-0035
Practice Address - Street 1:18676 WILLAMETTE DR
Practice Address - Street 2:SUITE 301
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-1718
Practice Address - Country:US
Practice Address - Phone:503-697-4746
Practice Address - Fax:503-635-0035
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD78361223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry