Y Jun Dental Corp

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

Y JUN DENTAL CORP

Practice address

17822 Beach Blvd Ste 342
Huntington Beach, CA 92647-7518

Phone

(714) 847-6044

NPI assigned

Dec 27, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Young Jun, DDS, MD

Title

President

Phone

(714) 847-6044

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Surf City Oral & Maxillofacial Surgery Doing business as

Locations

Practitioners 2

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

• Gary David Carlsen, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Huntington Beach, CA
  • NPI 1568527703
  NPD (past)
• Omid Niavarani, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Huntington Beach, CA
  • NPI 1104245976
  NPD (past)

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

{
    "created_epoch": "1545868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546646400000",
    "number": "1215409479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17822 BEACH BLVD STE 342",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477518",
            "telephone_number": "714-847-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17822 BEACH BLVD STE 342",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477518",
            "telephone_number": "714-847-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "Y JUN DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-27",
        "last_updated": "2019-01-05",
        "status": "A",
        "authorized_official_last_name": "JUN",
        "authorized_official_first_name": "YOUNG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-847-6044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR.  MARC TOSO",
            "identifier": "1932496809",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. GARY CARLSEN",
            "identifier": "1568527703",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surf City Oral & Maxillofacial Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Surf City Oral & Maxillofacial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephen Marc Wyman, M.D.
• Ryan Wyn, D.D.S.
• Patricia Wynne, MA LMFT
• Caroline Xanthakis
• Pedro Xuncax
• Ken Teruo Yabuki, D.D.S.
• Eman Yacoub, AMFT
• Wallace Seiichi Yagi, RPH
• Conan John Yamamoto
• Kayla Yamamoto

• Oral and Maxillofacial Surgery (Dentist) in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2019; 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.