Active NPI
Brian Yoon
- Dentist
- Henderson, NV
National Provider Identifier
1235829169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7908
- Practice address
- 10525 S Eastern Ave Ste 100
Henderson, NV 89052-3971 - Phone
- (702) 508-0906
- NPI assigned
- May 12, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7908 | NV | Primary |
Addresses
Primary practice location
10525 S Eastern Ave Ste 100
Henderson, NV 89052-3971
Mailing address
10000 S Maryland Pkwy Apt 1169
Las Vegas, NV 89183-6388
Phone (443) 694-1216
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231024004153 | NV | Order and Referring Only - Dentist | 6406202613 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7908 | NV | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yip Horizon Ridge Modern Dentistry, PC | Current | Accepting new patients |
Locations
10525 S Eastern Ave
Ste 100
Henderson, NV 89052
Phone (702) 508-0906
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Henderson, NV
- NPI 1821623059
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693872000000",
"number": "1235829169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10000 S MARYLAND PKWY APT 1169",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891836388",
"telephone_number": "443-694-1216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10525 S EASTERN AVE STE 100",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890523971",
"telephone_number": "702-508-0906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOON",
"first_name": "BRIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-12",
"last_updated": "2023-09-05",
"certification_date": "2023-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NV",
"license": "7908",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.