Active NPI
Shinjae Yoo
- General Practice Dentistry
- New Britain, CT
National Provider Identifier
1770968778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11440
- Practice address
- 446 S Main St
New Britain, CT 06051-3516 - Phone
- (860) 645-0111
- NPI assigned
- Jul 21, 2015
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11440 | CT | Primary |
Addresses
Primary practice location
446 S Main St
New Britain, CT 06051-3516
Mailing address
299 Colt Hwy
Apt 113
Farmington, CT 06032-3082
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- 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 |
|---|---|---|---|---|
| I20160720002672 | CT | Order and Referring Only - Dentist | 0648563130 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11440 | CT | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437436800000",
"number": "1770968778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "299 COLT HWY",
"address_2": "APT 113",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "060323082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "446 S MAIN ST",
"city": "NEW BRITAIN",
"state": "CT",
"postal_code": "060513516",
"telephone_number": "860-645-0111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOO",
"first_name": "SHINJAE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-21",
"last_updated": "2015-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CT",
"license": "11440",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Britain, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; 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.