Sage Sejong Yoo, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

30815 Issued in TX

Practice address

6675 S Custer Rd
McKinney, TX 75070

Phone

(469) 301-3212

NPI assigned

Jul 13, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 24, 2016 through May 24, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Sprout Dentistry for Kids PLLC

  • Pediatric Dentistry
  • McKinney, TX
  • NPI 1821651894
  NPD (past) Authorized official

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

{
    "created_epoch": "1373673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1508207994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 CHARDONNAY DR",
            "city": "FAIRVIEW",
            "state": "TX",
            "postal_code": "750691542",
            "telephone_number": "214-892-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6675 S CUSTER RD",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "75070",
            "telephone_number": "469-301-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOO",
        "first_name": "SAGE",
        "middle_name": "SEJONG",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-13",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1856322",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "30815",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "30815",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID - MCNA",
            "identifier": "32386",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yash Endodontics PLLC
• Trenton Isaiah Yeomans
• Yeti Womens Health PLLC
• Seleehom Yisihak, BCBA, LBA
• Dale Yoo, M.D.
• Vivienne Yoon, M.D.
• You First Telehealth LLC
• You First Telehealth LLC
• Allison Youderian
• Brett D. Young, MD

• Pediatric Dentistry in McKinney, TX
• Providers in McKinney, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.