Victor K Ryoo, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48670 Issued in CA

Practice address

1400 N Harbor Blvd Ste 106
Fullerton, CA 92835-4107

Phone

(562) 716-5193

Fax

(714) 484-1168

NPI assigned

Dec 15, 2006

Last updated

Aug 21, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Ryoo Dental, Inc

  • General Practice Dentistry
  • Fullerton, CA
  • NPI 1366858391
  NPD Authorized official
• Victor K. Ryoo, DDS, Inc

  • General Practice Dentistry
  • Fullerton, CA
  • NPI 1407919046
  NPD (past) Authorized official

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1053473108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 N HARBOR BLVD",
            "address_2": "SUITE 110",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352631",
            "telephone_number": "714-992-0030",
            "fax_number": "714-333-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N HARBOR BLVD STE 106",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354107",
            "telephone_number": "562-716-5193",
            "fax_number": "714-484-1168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYOO",
        "first_name": "VICTOR",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Renae Ruvalcaba
• Paige Ryan, PA-S
• Patricia Ann Ryan, D.D.S.
• Sue Kyung Ryo
• Ryoo Dental, Inc
• Cathy Ryu, PT, DPT
• Serra Eugenie Park Ryu, D.P.M.
• S.H. Lee Dental Corp (Eco Dental)
• Saadah Alrajab MD MPH Inc
• Rachelle Erin Saavedra

• General Practice Dentistry in Fullerton, CA
• Providers in Fullerton, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.