Individual provider Active NPI

Da Yung Lisa Yeo, DDS

  • General Practice Dentistry
  • Granada Hills, CA
National Provider Identifier
1043737042
Registry record updated Apr 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
103057 Issued in CA
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

Updated by the provider on Apr 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
103057CAMDGeneral 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.

Verify at the official NPI Registry.