Individual provider Active NPI

Seung Hyuk Yang, DMD

  • Dentist
  • Flushing, NY
National Provider Identifier
1205827482
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
049240 Issued in NY
Practice address
2950 Union St
Suite 201
Flushing, NY 11354-2200
Phone
(718) 321-2885
Fax
(718) 321-2802
NPI assigned
Nov 4, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 049240 NY Primary

Addresses

Primary practice location

2950 Union St
Suite 201
Flushing, NY 11354-2200

Mailing address

2950 Union St
Suite 201
Flushing, NY 11354-2200
Phone (718) 321-2885

Other identifiers 1

IdentifierTypeStateIssuer
02156081MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20160105000470 NY Order and Referring Only - DentistPractitioner - Dentist 7517269871

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
049240NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236124800000",
    "number": "1205827482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 UNION ST",
            "address_2": "SUITE 201",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113542200",
            "telephone_number": "718-321-2885",
            "fax_number": "718-321-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 UNION ST",
            "address_2": "SUITE 201",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113542200",
            "telephone_number": "718-321-2885",
            "fax_number": "718-321-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "SEUNG",
        "middle_name": "HYUK",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2009-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "049240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02156081",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.