Jack Yu DDS Inc

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

48412 Issued in CA

Legal business name

JACK YU DDS INC

Doing business as

Grandview Endodontics

Practice address

13768 Roswell Ave Ste 210
Chino, CA 91710-1407

Phone

(909) 591-1055

NPI assigned

Mar 15, 2018

Last updated

Apr 25, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jack T Yu

Title

Owner

Phone

(909) 591-1055

Specialties & licenses 1

Addresses

Other names 1

• Grandview Endodontics Doing business as

Locations

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

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524614400000",
    "number": "1144723107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13768 ROSWELL AVE STE 210",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917101407",
            "telephone_number": "909-591-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13768 ROSWELL AVE STE 210",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917101407",
            "telephone_number": "909-591-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK YU DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-15",
        "last_updated": "2018-04-25",
        "status": "A",
        "authorized_official_last_name": "YU",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-591-1055",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "48412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grandview Endodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Endodontics in Chino, CA
• Providers in Chino, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2018; 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.