Provider Demographics
NPI:1447653746
Name:MAC, MAKSIM AND YANG DENTAL PARTNERSHIP A GENERAL PARTNERSHIP
Entity type:Organization
Organization Name:MAC, MAKSIM AND YANG DENTAL PARTNERSHIP A GENERAL PARTNERSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:XUONG
Authorized Official - Last Name:MAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-383-7623
Mailing Address - Street 1:8534 HOPSEED LN
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-4166
Mailing Address - Country:US
Mailing Address - Phone:240-383-7623
Mailing Address - Fax:
Practice Address - Street 1:8534 HOPSEED LN
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-4166
Practice Address - Country:US
Practice Address - Phone:240-383-7623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-30
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA354291223G0001X
CA418081223P0300X
CA455851223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty