Individual provider Active NPI

Olivia Yoon, DDS

  • Dentist
  • Dallas, TX
National Provider Identifier
1265046114
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
36635 Issued in TX
Practice address
8062 Ferguson Rd
Dallas, TX 75228-5848
Phone
(214) 200-4209
NPI assigned
Sep 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 36635 TX Primary

Addresses

Primary practice location

8062 Ferguson Rd
Dallas, TX 75228-5848

Mailing address

4343 Congress Ave Apt 235
Dallas, TX 75219-2613
Phone (785) 393-8320

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
36635TXMDDentist

Interoperability endpoints

  • Direct secure messaging: oliviah.yoon.p1@direct.affiniahealthcare.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1265046114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 CONGRESS AVE APT 235",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752192613",
            "telephone_number": "785-393-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8062 FERGUSON RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752285848",
            "telephone_number": "214-200-4209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOON",
        "first_name": "OLIVIA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-08",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "36635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.