Individual provider Active NPI

Sang Hun Yoon, DDS

  • General Practice Dentistry
  • Chattanooga, TN
National Provider Identifier
1154483592
Registry record updated Oct 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10593 Issued in TN
Practice address
4610 Brainerd Rd Ste 2
Chattanooga, TN 37411-3835
Phone
(423) 622-6552
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 48571 CA
General Practice Dentistry 1223G0001X 10593 TN Primary

Addresses

Primary practice location

4610 Brainerd Rd Ste 2
Chattanooga, TN 37411-3835

Mailing address

4610 Brainerd Rd Ste 2
Chattanooga, TN 37411-3835
Phone (423) 622-6552

Other practice location 1

912 E Main St
Barstow, CA 92311-2406
Phone (760) 255-1206

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
48571CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538611200000",
    "number": "1154483592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4610 BRAINERD RD STE 2",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374113835",
            "telephone_number": "423-622-6552",
            "fax_number": "423-622-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 BRAINERD RD STE 2",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374113835",
            "telephone_number": "423-622-6552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "912 E Main St",
            "address_purpose": "LOCATION",
            "city": "Barstow",
            "state": "CA",
            "postal_code": "923112406",
            "country_code": "US",
            "telephone_number": "760-255-1206",
            "fax_number": "760-256-2287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOON",
        "first_name": "SANG",
        "middle_name": "HUN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2018-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48571",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "10593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.