Active NPI
Sang Won Yoo, D.D.S.
- General Practice Dentistry
- Riverside, CA
National Provider Identifier
1861780561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 60502
- Practice address
- 6862 Palm Ave
Riverside, CA 92506-2812 - Phone
- (951) 683-5490
- NPI assigned
- Jul 14, 2011
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 60502 | CA | Primary |
Addresses
Primary practice location
6862 Palm Ave
Riverside, CA 92506-2812
Mailing address
251 W Rincon St Unit 111
Corona, CA 92880-2091
Phone (951) 520-3684
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60502 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wayne R Low DDS Inc | 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.
-
- Dental Clinic/Center
- Riverside, CA
- NPI 1255434676
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447286400000",
"number": "1861780561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "251 W RINCON ST UNIT 111",
"city": "CORONA",
"state": "CA",
"postal_code": "928802091",
"telephone_number": "951-520-3684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6862 PALM AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925062812",
"telephone_number": "951-683-5490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOO",
"first_name": "SANG",
"middle_name": "WON",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-14",
"last_updated": "2015-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "60502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.