Individual provider Active NPI

Pyi Soe, DDS

  • Dentist
  • Yorba Linda, CA
National Provider Identifier
1508918699
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D46973 Issued in CA
Practice address
17540 Yorba Linda Blvd
Yorba Linda, CA 92886-3825
Phone
(714) 996-4057
Fax
(714) 996-4158
NPI assigned
Jan 17, 2007
Sex
Male
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
Dentist 122300000X D46973 CA Primary

Addresses

Primary practice location

17540 Yorba Linda Blvd
Yorba Linda, CA 92886-3825

Mailing address

17540 Yorba Linda Blvd
Yorba Linda, CA 92886-3825
Phone (714) 996-4057

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200110001755 CA Practitioner - Oral SurgeryPractitioner - Dentist 3375975766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D46973CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508918699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17540 YORBA LINDA BLVD",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928863825",
            "telephone_number": "714-996-4057",
            "fax_number": "714-996-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17540 YORBA LINDA BLVD",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928863825",
            "telephone_number": "714-996-4057",
            "fax_number": "714-996-4158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOE",
        "first_name": "PYI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "D46973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorba Linda, CA

Sources for this page

Verify at the official NPI Registry.