NPIMap

Organization Active NPI

KW Youn DDS Dental Corporation

  • Dentist
  • Anaheim, CA
National Provider Identifier
1801320775
Registry record updated Apr 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
64609 Issued in CA
Legal business name
KW YOUN DDS DENTAL CORPORATION
Practice address
1134 N State College Blvd
Suite C
Anaheim, CA 92806-2771
Phone
(714) 772-2698
NPI assigned
Apr 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2017

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

Authorized official

Name
Dr. Kiwon Youn
Title
President
Phone
(765) 543-3663

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 64609 CA Primary

Addresses

Primary practice location

1134 N State College Blvd
Suite C
Anaheim, CA 92806-2771

Mailing address

1134 N State College Blvd
Suite C
Anaheim, CA 92806-2771
Phone (714) 772-2698

National Provider Directory

National Provider Directory

Locations

1134 N State College Blvd
Ste C
Anaheim, CA 92806
Phone (714) 772-2698

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492387200000",
    "number": "1801320775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1134 N STATE COLLEGE BLVD",
            "address_2": "SUITE C",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928062771",
            "telephone_number": "714-772-2698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1134 N STATE COLLEGE BLVD",
            "address_2": "SUITE C",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928062771",
            "telephone_number": "714-772-2698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KW YOUN DDS DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-17",
        "last_updated": "2017-04-17",
        "status": "A",
        "authorized_official_last_name": "YOUN",
        "authorized_official_first_name": "KIWON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "765-543-3663",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "64609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; 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.