NPIMap

Organization Active NPI

Stephan Yoon DMD Inc

Doing business as Salt & Light Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Irvine, CA
National Provider Identifier
1922683770
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
STEPHAN YOON DMD INC
Doing business as
Salt & Light Orthodontics
Practice address
113 Waterworks Way Ste 215
Irvine, CA 92618-3176
Phone
(949) 412-5734
NPI assigned
Mar 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Authorized official

Name
Dr. Stephanie P Purnomo, DDS MSNPI 1609391820
Title
Orthodontist/Owner
Phone
(415) 859-8135

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

113 Waterworks Way Ste 215
Irvine, CA 92618-3176

Mailing address

113 Waterworks Way Ste 215
Irvine, CA 92618-3176
Phone (949) 412-5734

Other names 1

  • Salt & Light Orthodontics Doing business as

National Provider Directory

National Provider Directory

Locations

113 Waterworks Way
Ste 215
Irvine, CA 92618
Phone (949) 412-5734

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1615507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615507200000",
    "number": "1922683770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 WATERWORKS WAY STE 215",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183176",
            "telephone_number": "949-412-5734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 WATERWORKS WAY STE 215",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183176",
            "telephone_number": "949-412-5734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHAN YOON DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-12",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A",
        "authorized_official_last_name": "PURNOMO",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "ORTHODONTIST/OWNER",
        "authorized_official_telephone_number": "415-859-8135",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Salt & Light Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.