NPIMap

Organization Active NPI

Carol Yun PC

  • General Practice Dentistry
  • Cambridge, MA
National Provider Identifier
1073680039
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17123 Issued in MA
Legal business name
CAROL YUN PC
Doing business as
Cambridge Dental Associates
Practice address
921 Massachusetts Avenue
Cambridge, MA 02139
Phone
(617) 492-8210
Fax
(617) 876-7390
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Carol K Yun, DMD
Title
President
Phone
(617) 492-8210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 17123 MA Primary

Addresses

Primary practice location

921 Massachusetts Avenue
Cambridge, MA 02139

Mailing address

921 Massachusetts Avenue
Cambridge, MA 02139
Phone (617) 492-8210

Other names 1

  • Cambridge Dental Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cambridge Dental Annex2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

921 Massachusetts Ave
Cambridge, MA 02139
Phone (617) 492-8210

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073680039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 MASSACHUSETTS AVENUE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "02139",
            "telephone_number": "617-492-8210",
            "fax_number": "617-876-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 MASSACHUSETTS AVENUE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "02139",
            "telephone_number": "617-492-8210",
            "fax_number": "617-876-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROL YUN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YUN",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-492-8210",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "17123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cambridge Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.