Sokbunntha Yan, R.D.H.A.P

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

804 Issued in CA

Practice address

5810 Fidler Ave
Lakewood, CA 90712-1251

Phone

(562) 235-6403

NPI assigned

Nov 6, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1083215982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5810 FIDLER AVE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121251",
            "telephone_number": "562-235-6403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5810 FIDLER AVE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121251",
            "telephone_number": "562-235-6403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAN",
        "first_name": "SOKBUNNTHA",
        "credential": "R.D.H.A.P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-06",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "30940",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wtu Fitness and Post Rehabilitation Center
• Hao Wu, D.P.M.
• Hui-Chun Wu
• Katie Mika Yamaguchi
• Alfred Mitsuru Yamamoto, M.D.
• Warren Timothy Yan, PA-C
• Seung Mok Yang, LAC
• Shenq Kae Yang, PT
• Kevin Yao, PHARMD
• Yashwant Giri, MD, Inc

• Dental Hygienist in Lakewood, CA
• Providers in Lakewood, CA by specialty
• Dental Hygienist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.