Songchin Yu, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

019024585 Issued in IL

Practice address

150 S Kennedy Dr
23A
Carpentersville, IL 60110-2091

Phone

(847) 551-1199

Fax

(847) 783-5282

NPI assigned

Apr 1, 2009

Last updated

Apr 1, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carpentersville Dental Care, LTD.

  • General Practice Dentistry
  • Carpentersville, IL
  • NPI 1023007234
  NPD (past) Authorized official

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238544000000",
    "number": "1851533178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S. KENNEDY DRIVE SUITE 23A",
            "city": "CARPENTERSVILLE",
            "state": "IL",
            "postal_code": "601102094",
            "telephone_number": "847-551-1199",
            "fax_number": "847-783-5282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S KENNEDY DR",
            "address_2": "23A",
            "city": "CARPENTERSVILLE",
            "state": "IL",
            "postal_code": "601102091",
            "telephone_number": "847-551-1199",
            "fax_number": "847-783-5282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YU",
        "first_name": "SONGCHIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-01",
        "last_updated": "2009-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019024585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co. (Walgreens #6764)
• Corey J Walther, D.D.S.
• Bryan Paul Welder, MPT
• Wellness & Nutrition Center
• Wellness & Nutrition Center, Inc.
• Kristin Zambreno

• Dentist in Carpentersville, IL
• Providers in Carpentersville, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; 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.

Verify at the official NPI Registry.