John Woong Yang, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019025467 Issued in IL

Practice address

781 S McHenry Ave
Suite a
Crystal Lake, IL 60014-7444

Phone

(815) 459-3740

NPI assigned

May 27, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

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.

• Tru Dental Illinois, P.C.

  • General Practice Dentistry
  • Crystal Lake, IL
  • NPI 1902481369
  NPD (past)

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1619970332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 S PRAIRIE AVE",
            "address_2": "APT 3103",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053403",
            "telephone_number": "847-722-0183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 S MCHENRY AVE",
            "address_2": "SUITE A",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147444",
            "telephone_number": "815-459-3740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "JOHN",
        "middle_name": "WOONG",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Eileen Work, M.S., CCC-SLP/L
• Diana Wozniak
• Heather Geeves Wright, M.S., CCC-SLP
• Sylwia Katarzyna Wronka, PHARMD
• Catherine Wysocka
• Reanna Denise Yarveicy
• Ellen L Young, LCPC
• Mary E Young
• Andrew J Yu, M.D.
• Dustin Yuhn, PHARMD

• General Practice Dentistry in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.