Individual provider Active NPI

Sang Pil Yu

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1639488760
Registry record updated Oct 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
26066 Issued in TX
Practice address
3010 LBJ Fwy
Dallas, TX 75234-7770
Phone
(972) 444-8888
NPI assigned
Oct 7, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 26066 TX Primary

Addresses

Primary practice location

3010 LBJ Fwy
Dallas, TX 75234-7770

Mailing address

3010 LBJ Fwy
Dallas, TX 75234-7770

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

State licenses

LicenseStateTypeSpecialty
26066TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286409600000",
    "number": "1639488760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 LBJ FWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752347770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 LBJ FWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752347770",
            "telephone_number": "972-444-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YU",
        "first_name": "SANG PIL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-07",
        "last_updated": "2010-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "26066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; 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.