Active NPI
Richard Yoo, DDS
- Dentist
- Oakville, WA
National Provider Identifier
1417515214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901023195
- Practice address
- 21 Niederman Rd
Oakville, WA 98568-8904 - Phone
- (360) 709-1659
- NPI assigned
- Jun 5, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901023195 | MI | Primary |
Addresses
Primary practice location
21 Niederman Rd
Oakville, WA 98568-8904
Mailing address
21 Niederman Rd
Oakville, WA 98568-8904
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2901023195 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Confederated Tribes of the Chehalis Reservation | Past | Accepting new patients |
Interoperability endpoints
- ryoo807227@direct.ochin.org
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.
-
- Clinic/Center
- Oakville, WA
- NPI 1346383379
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724716800000",
"number": "1417515214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 NIEDERMAN RD",
"city": "OAKVILLE",
"state": "WA",
"postal_code": "985688904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 NIEDERMAN RD",
"city": "OAKVILLE",
"state": "WA",
"postal_code": "985688904",
"telephone_number": "360-709-1659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOO",
"first_name": "RICHARD",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-05",
"last_updated": "2024-08-27",
"certification_date": "2024-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901023195",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.