Active NPI
Kyubo Yoon, D.D.S.
- Student in an Organized Health Care Education/Training Program
- New York, NY
National Provider Identifier
1508350380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 425 Main Street
Suite PH1C
New York, NY 10044 - Phone
- (647) 298-5469
- NPI assigned
- Jun 15, 2018
- Reactivated
- Jan 31, 2019
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
425 Main Street
Suite PH1C
New York, NY 10044
Mailing address
5 Northtown Way
Suite 2114
Toronto, ONTARIO M2N 7A1
CA
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581292800000",
"number": "1508350380",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "5 NORTHTOWN WAY",
"address_2": "SUITE 2114",
"city": "TORONTO",
"state": "ONTARIO",
"postal_code": "M2N 7A1"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 MAIN STREET",
"address_2": "SUITE PH1C",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10044",
"telephone_number": "647-298-5469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOON",
"first_name": "KYUBO",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-15",
"last_updated": "2020-02-10",
"certification_date": "2020-02-10",
"deactivation_date": "2019-01-25",
"reactivation_date": "2019-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.