Individual provider Active NPI

Inae J Suh, DDS

  • Dentist
  • Anaheim, CA
National Provider Identifier
1619034998
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
38368 Issued in CA
Practice address
515 S Beach Blvd Ste D
Anaheim, CA 92804-1812
Phone
(714) 828-6500
Fax
(714) 828-4365
NPI assigned
Jan 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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 38368 CA Primary

Addresses

Primary practice location

515 S Beach Blvd Ste D
Anaheim, CA 92804-1812

Mailing address

515 S Beach Blvd Ste D
Anaheim, CA 92804-1812
Phone (714) 828-6500

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
I20160129001965 CA Order and Referring Only - DentistPractitioner - Dentist 6901109677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38368CAMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Byung Un Yoo DDS Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619034998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 S BEACH BLVD STE D",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928041812",
            "telephone_number": "714-828-6500",
            "fax_number": "714-828-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 S BEACH BLVD STE D",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928041812",
            "telephone_number": "714-828-6500",
            "fax_number": "714-828-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUH",
        "first_name": "INAE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "38368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.