Derek Hyun Dental Corp

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

40949 Issued in CA

Legal business name

DEREK HYUN DENTAL CORP

Practice address

13025 Pomerado Rd Ste B
Poway, CA 92064-4248

Phone

(858) 679-2838

Fax

(858) 679-2837

NPI assigned

Jul 25, 2017

Organization subpart

No

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

Authorized official

Name

Ms. Maricela Vizcarra

Title

Office Manager

Phone

(858) 679-2838

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Derek D. Hyun, D.D.S.

  • General Practice Dentistry
  • Poway, CA
  • NPI 1487875464
  NPD (past)

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1376066977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13025 POMERADO RD STE B",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920644248",
            "telephone_number": "858-679-2838",
            "fax_number": "858-679-2837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13025 POMERADO RD STE B",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920644248",
            "telephone_number": "858-679-2838",
            "fax_number": "858-679-2837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEREK HYUN DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-25",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "VIZCARRA",
        "authorized_official_first_name": "MARICELA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "858-679-2838",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "40949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Delgado
• Jenniffer Denis Amador
• Jacob Denoyer, BSN, RN
• Dental Corporation of Lance Rygg DDS (Poway Family Dental Group)
• Bahram Derakhshan
• Ashley Deronde
• Josette Carmen Desrosiers
• Jeslynn Detwiler
• Devoted Lifestyle Housing LLC. (Devoted Lifestyle)
• Christopher S Dewitt

• Dental Clinic/Center in Poway, CA
• Providers in Poway, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.