Kwangjae Yeo DDS PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

29206 Issued in TX

Legal business name

KWANGJAE YEO DDS PLLC

Practice address

1894 Royal LN
Suite 104
Dallas, TX 75229-3182

Phone

(469) 703-9819

NPI assigned

Apr 18, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Kwangjae Yeo, DDS

Title

President

Phone

(469) 703-9819

Specialties & licenses 1

Addresses

Other names 1

• Fresh Smile Dental Care Doing business as

Locations

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

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466553600000",
    "number": "1609220490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1894 ROYAL LN",
            "address_2": "SUITE 104",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752293182",
            "telephone_number": "469-703-9819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1894 ROYAL LN",
            "address_2": "SUITE 104",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752293182",
            "telephone_number": "469-703-9819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KWANGJAE YEO DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-18",
        "last_updated": "2016-06-22",
        "status": "A",
        "authorized_official_last_name": "YEO",
        "authorized_official_first_name": "KWANGJAE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-703-9819",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "29206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fresh Smile Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelly Kwak
• Andrea Lee Kwan
• Laura L. Kwan, M.D.
• Lily Kwan
• Tracy Kwan, PA-C
• Gail Edna Kwarciany, RN MSN BC OCN AOCNS
• Thomas James Kwarcinski, MD
• Nora Carmen Kweik, DDS
• Adelaide Kwon
• Alvin Guyun Kwon, MD

• Dentist in Dallas, TX
• Providers in Dallas, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.