Sunkoo Yoon, DDS
Individual provider Active NPI Dentist · Crownpoint, NM
NPI 1013131382 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1013131382
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 9748 (NJ)
- Practice address
- Highway 371 Junction Route 9
Crownpoint, NM 87313-0358 - Phone
- (505) 786-5291
- Fax
- (505) 786-6440
- NPI assigned
- Apr 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9748 | NJ | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9748 | NJ | Yes |
Addresses
Primary practice location
Highway 371 Junction Route 9
Crownpoint, NM 87313-0358
Mailing address
PO Box 358
Crownpoint, NM 87313-0358
Phone (505) 786-5291
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 96952881 | Medicaid | NM |
Other providers in Crownpoint, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.