Active NPI
Shuichi Yamaguchi, DDS PS
- Dentist
- Everett, WA
National Provider Identifier
1790883650
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Nov 20, 2024.
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7482
- Practice address
- 10217 19TH Ave SE
Ste 203
Everett, WA 98208 - Phone
- (425) 385-8130
- Fax
- (425) 385-2658
- NPI assigned
- Sep 21, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 7482 | WA | Primary |
Addresses
Primary practice location
10217 19TH Ave SE
Ste 203
Everett, WA 98208
Mailing address
6113 St Andrews Dr
Mukilteo, WA 98275
Phone (425) 349-1343
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7482 | WA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yun M Kang DDS PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790883650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6113 ST ANDREWS DR",
"city": "MUKILTEO",
"state": "WA",
"postal_code": "98275",
"telephone_number": "425-349-1343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10217 19TH AVE SE",
"address_2": "STE 203",
"city": "EVERETT",
"state": "WA",
"postal_code": "98208",
"telephone_number": "425-385-8130",
"fax_number": "425-385-2658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAMAGUCHI",
"first_name": "SHUICHI",
"name_prefix": "Mr.",
"credential": "DDS PS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "7482",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.