Individual provider Active NPI

Joseph S. Yoon, D.D.S.

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1023010766
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
51815 Issued in CA
Practice address
3460 Wilshire Blvd
104
Los Angeles, CA 90010-2206
Phone
(213) 383-3460
Fax
(213) 383-3433
NPI assigned
Aug 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 51815 CA Primary

Addresses

Primary practice location

3460 Wilshire Blvd
104
Los Angeles, CA 90010-2206

Mailing address

3460 Wilshire Blvd
104
Los Angeles, CA 90010-2206
Phone (213) 383-3460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150706001111 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4183936198

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
51815CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Yoon Dental Corp Dentist PastSince Aug 1, 2008 Accepting new patients
Audrey Jung-Sun Yoon DDS Ms Dental Corp Dentist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1023010766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3460 WILSHIRE BLVD",
            "address_2": "104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102206",
            "telephone_number": "213-383-3460",
            "fax_number": "213-383-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 WILSHIRE BLVD",
            "address_2": "104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102206",
            "telephone_number": "213-383-3460",
            "fax_number": "213-383-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOON",
        "first_name": "JOSEPH",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "51815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.