Active NPI
Anthony Y Yoon, D.D.S.
- Dentist
- Fort Worth, TX
National Provider Identifier
1730305772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 20948
- Practice address
- 2717 8TH Ave
Fort Worth, TX 76110-3041 - Phone
- (817) 924-7670
- Fax
- (817) 924-7646
- NPI assigned
- Apr 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 20948 | TX | Primary |
Addresses
Primary practice location
2717 8TH Ave
Fort Worth, TX 76110-3041
Mailing address
600 Gray Stone Lane
Richardson, TX 75081
Phone (214) 632-0487
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151230000409 | TX | Order and Referring Only - Dentist | 4880996396 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20948 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366848000000",
"number": "1730305772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 GRAY STONE LANE",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "75081",
"telephone_number": "214-632-0487",
"fax_number": "817-924-7646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2717 8TH AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761103041",
"telephone_number": "817-924-7670",
"fax_number": "817-924-7646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOON",
"first_name": "ANTHONY",
"middle_name": "Y",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-18",
"last_updated": "2013-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "20948",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; 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.