Seungjae Yang, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2.014153 Issued in CT

Practice address

31 Liberty St Ste 311
Southington, CT 06489-3114

Phone

(860) 628-0385

NPI assigned

Nov 27, 2024

Last updated

Nov 27, 2024By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Southington Dental Assoicates PC

  • General Practice Dentistry
  • Southington, CT
  • NPI 1912117482
  NPD (past)

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

{
    "created_epoch": "1732665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1700602463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 LIBERTY ST STE 311",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064893114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 LIBERTY ST STE 311",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064893114",
            "telephone_number": "860-628-0385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "SEUNGJAE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-27",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "2.014153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Vetrano Wolf, LCSW
• Kathleen Wozniak, RPH
• Yiqing Xiang, MT-BC
• Rajwardhan Yadav, M.D., PH.D.
• Yale Home Care Physicians Inc (828 - Urgent Care)
• Albert Young, LADC
• Iwona Zalewska
• Beata Zaloba, PTA
• Theodore Walter Zdeblick, DDS
• Maya Markovna Zeiberg, RDH, MSDH

• Dentist in Southington, CT
• Providers in Southington, CT by specialty
• Dentist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; 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.