Jack Yeung, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

63460 Issued in CA

Practice address

1222 McClellan Dr Apt 2
Los Angeles, CA 90025-1010

Phone

(415) 730-2818

NPI assigned

Jun 17, 2014

Last updated

Jun 17, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sequoia Pediatric Dentistry

  • Pediatric Dentistry
  • Redwood City, CA
  • NPI 1801346317
  Authorized official Same address or phone

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1447664578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 MCCLELLAN DR APT 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251010",
            "telephone_number": "415-730-2818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 MCCLELLAN DR APT 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251010",
            "telephone_number": "415-730-2818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEUNG",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-17",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "63460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guadalupe Yetter, MPT
• Pallavi Yetur
• Alexis Kant Yetwin, PH.D.
• Yeuchun Cindy Zheng-Heczko, MD, Inc
• Glendy Yeung
• Jennifer Yuen-Yan Yeung, MD
• Jonathan C Yeung, D.D.S.
• Karen Kar-Ling Yeung, OD
• Louise Y Yeung, M.D.
• Lucy Yeung, MD

• Pediatric Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.