Individual provider Active NPI

Sunny Yu, DDS

  • General Practice Dentistry
  • Fayetteville, NC
National Provider Identifier
1396841227
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7510 Issued in NC
Practice address
2029 Valleygate Dr
Suite 201
Fayetteville, NC 28304-3688
Phone
(910) 485-8884
Fax
(910) 485-8287
NPI assigned
Sep 16, 2006
Sex
Female
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
General Practice Dentistry 1223G0001X 7510 NC Primary

Addresses

Primary practice location

2029 Valleygate Dr
Suite 201
Fayetteville, NC 28304-3688

Mailing address

2029 Valleygate Dr
Suite 201
Fayetteville, NC 28304-3688
Phone (910) 485-8884

Other identifiers 1

IdentifierTypeStateIssuer
89902C2MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20150609001889 NC Practitioner - Oral Surgery 1456672922 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7510NCMDGeneral Practice Dentistry

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.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396841227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2029 VALLEYGATE DR",
            "address_2": "SUITE 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043688",
            "telephone_number": "910-485-8884",
            "fax_number": "910-485-8287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2029 VALLEYGATE DR",
            "address_2": "SUITE 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043688",
            "telephone_number": "910-485-8884",
            "fax_number": "910-485-8287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YU",
        "first_name": "SUNNY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89902C2",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.