Individual provider Active NPI

Sammy W Yung, DDS

  • Dentist
  • Westminster, CA
National Provider Identifier
1295862902
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
40326 Issued in CA
Practice address
10051 Bolsa Ave
# A1
Westminster, CA 92683
Phone
(714) 839-6631
Fax
(714) 839-2475
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 40326 CA Primary

Addresses

Primary practice location

10051 Bolsa Ave
# A1
Westminster, CA 92683

Mailing address

10051 Bolsa Ave
# A1
Westminster, CA 92683
Phone (714) 839-6631

Other identifiers 1

IdentifierTypeStateIssuer
B40326MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160425000503 CA Order and Referring Only - DentistPractitioner - Dentist 8628377736

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tam Ngo DDS, Inc. Dentist Past Accepting new patients
Tien Thi My Ngo DDS Inc Dentist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295862902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10051 BOLSA AVE",
            "address_2": "# A1",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "92683",
            "telephone_number": "714-839-6631",
            "fax_number": "714-839-2475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10051 BOLSA AVE",
            "address_2": "# A1",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "92683",
            "telephone_number": "714-839-6631",
            "fax_number": "714-839-2475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUNG",
        "first_name": "SAMMY",
        "middle_name": "W",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "40326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B40326",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CA

Sources for this page

Verify at the official NPI Registry.