Yongsok DO, D.M.D

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DT-2316 Issued in HI

Practice address

91-2139 Fort Weaver Rd
Suite 301
Ewa Beach, HI 96706-3607

Phone

(808) 680-9411

Fax

(808) 676-9847

NPI assigned

Jul 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

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

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 and National Provider Directory roles.

• Yongsok DO, D.M.D., L.L.C

  • Pediatric Dentistry
  • Ewa Beach, HI
  • NPI 1720378664
  NPD (past) Authorized official

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302566400000",
    "number": "1730104407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-2139 FORT WEAVER RD",
            "address_2": "SUITE 301",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967063607",
            "telephone_number": "808-680-9411",
            "fax_number": "808-676-9847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-2139 FORT WEAVER RD",
            "address_2": "SUITE 301",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967063607",
            "telephone_number": "808-680-9411",
            "fax_number": "808-676-9847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "YONGSOK",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2011-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS035178",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "HI",
            "license": "DT-2316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Macaele Diane Devries, MA, MS
• Mark Daniel Dichner, PH.D.
• Randy Agbayani Diga
• Leticia Garcia Diniega, MD
• Jamay Patricia Dizon, LPN, RBT
• Angela Doi
• Nancy Cardoso Dominesey
• Alexis Michaela Ednilao Domingo, ATC
• Myra Krizzha Mae Ribao Domingo, RN
• Samira Domingo, RN, CLC

• All providers in Ewa Beach, HI
• Pediatric Dentistry in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2011; 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.