Individual provider Active NPI

Alvyn Yeoh, DDS

  • General Practice Dentistry
  • Southport, CT
National Provider Identifier
1811203458
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
010749 Issued in CT
Practice address
8 John St
Southport, CT 06890-1437
Phone
(203) 319-1300
NPI assigned
Aug 20, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 055796 NY
General Practice Dentistry 1223G0001X 010749 CT Primary

Addresses

Primary practice location

8 John St
Southport, CT 06890-1437

Mailing address

8 John St
Southport, CT 06890-1437
Phone (203) 319-1300

Other practice location 1

2016 Bronxdale Ave Ste 303
Bronx, NY 10462-3389
Phone (718) 792-7972

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20220117000032 NY Practitioner - Dentist 5395137715 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Union Community Health Center, Inc. CurrentSince Oct 12, 2021 Accepting new patients
Bronx Park Dental PC General Practice Past Accepting new patients

Locations

260 E 188th St
Bronx, NY 10458
Phone (718) 618-8236

2016 Bronxdale Ave
Ste 303
Bronx, NY 10462
Phone (718) 792-7972

2021 Grand Concourse
Bronx, NY 10453
Phone (718) 299-2800

Organizations & group practices 2

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": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1811203458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 JOHN ST",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901437",
            "telephone_number": "203-319-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 JOHN ST",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901437",
            "telephone_number": "203-319-1300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2016 Bronxdale Ave Ste 303",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104623389",
            "country_code": "US",
            "telephone_number": "718-792-7972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YEOH",
        "first_name": "ALVYN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "055796",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, CT

Sources for this page

Verify at the official NPI Registry.