Organization Active NPI

Yoonbum Bae DDS Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Los Angeles, CA
National Provider Identifier
1912469883
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
YOONBUM BAE DDS INC
Practice address
866 S Westmoreland Ave Ste 102
Los Angeles, CA 90005-2372
Phone
(213) 352-1366
NPI assigned
Apr 1, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Authorized official

Name
Michael Yoonbum Bae, DDS
Title
President
Phone
(213) 352-1366

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

866 S Westmoreland Ave Ste 102
Los Angeles, CA 90005-2372

Mailing address

866 S Westmoreland Ave Ste 102
Los Angeles, CA 90005-2372
Phone (213) 352-1366

National Provider Directory

National Provider Directory

Locations

866 S Westmoreland Ave
Ste 102
Los Angeles, CA 90005
Phone (213) 352-1366

NPI Registry JSON

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554076800000",
    "number": "1912469883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "866 S WESTMORELAND AVE STE 102",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900052372",
            "telephone_number": "213-352-1366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "866 S WESTMORELAND AVE STE 102",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900052372",
            "telephone_number": "213-352-1366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOONBUM BAE DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-01",
        "last_updated": "2019-04-01",
        "status": "A",
        "authorized_official_last_name": "BAE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "YOONBUM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-352-1366",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

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