Kristopher Antonio Yen

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN1858401 Issued in MA

Practice address

32 Kathryn Dr
Bridgeport, CT 06610-1264

Phone

(203) 243-9237

NPI assigned

Jun 20, 2019

Last updated

Jul 3, 2019By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Charlestown Dental Care

  • Dental Clinic/Center
  • Charlestown, MA
  • NPI 1316647662
  NPD Authorized official

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1891355814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 KATHRYN DR",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066101264",
            "telephone_number": "203-243-9237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 KATHRYN DR",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066101264",
            "telephone_number": "203-243-9237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEN",
        "first_name": "KRISTOPHER",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-20",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1858401",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danwen Yang
• Patrick Yang, MD
• Tenzin Yangzom
• Kyle Christopher Yano, DO
• Abdullah Yaylagul
• Paola Yepez, MD
• Cakir-Emine Yildiz
• Juliet Aaferemwin Yirerong, M.D.
• Syn Hae Yoon, MD
• Mishel Yoshuva, DDS

• General Practice Dentistry in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; 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.