Individual provider Active NPI

Jun Young Yang, D.D.S

  • General Practice Dentistry
  • Anaheim, CA
National Provider Identifier
1336684091
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
101108 Issued in CA
Practice address
3006 W Lincoln Ave
Anaheim, CA 92801-6129
Phone
(714) 828-0508
NPI assigned
Jan 4, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 101108 CA Primary
Dentist 122300000X 101108 CA

Addresses

Primary practice location

3006 W Lincoln Ave
Anaheim, CA 92801-6129

Mailing address

3006 W Lincoln Ave
Anaheim, CA 92801-6129
Phone (714) 828-0508

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
I20201013001623 CA Practitioner - DentistPractitioner - Oral Surgery 6901226901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101108CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jun Young Yang DDS, Inc CurrentSince Oct 22, 2020 Accepting new patients
Jin Anaheim Park DDS, Inc General Practice PastSince Oct 22, 2020 Accepting new patients

Locations

3006 W Lincoln Ave
Anaheim, CA 92801
Phone (714) 828-0508

936 Crenshaw Blvd
Ste 100
Los Angeles, CA 90019

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": "1483488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1336684091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3006 W LINCOLN AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928016129",
            "telephone_number": "714-828-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3006 W LINCOLN AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928016129",
            "telephone_number": "714-828-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "JUN YOUNG",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-04",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "101108",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "101108",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.