Active NPI
Da Yung Lisa Yeo, DDS
- General Practice Dentistry
- Granada Hills, CA
National Provider Identifier
1043737042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 103057
- Practice address
- 17526 Chatsworth St
Granada Hills, CA 91344-5719 - Phone
- (818) 832-2828
- NPI assigned
- Aug 29, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 103057 | CA | Primary |
Addresses
Primary practice location
17526 Chatsworth St
Granada Hills, CA 91344-5719
Mailing address
235 S San Pedro St Apt 248
Los Angeles, CA 90012-3573
Phone (917) 635-7564
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103057 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556582400000",
"number": "1043737042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 S SAN PEDRO ST APT 248",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900123573",
"telephone_number": "917-635-7564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17526 CHATSWORTH ST",
"city": "GRANADA HILLS",
"state": "CA",
"postal_code": "913445719",
"telephone_number": "818-832-2828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YEO",
"first_name": "DA YUNG",
"middle_name": "LISA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-29",
"last_updated": "2019-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "103057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Granada Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.