Individual provider Active NPI

Dong J. Yoo, DDS

  • Dentist
  • Garden Grove, CA
National Provider Identifier
1932465622
Registry record updated Apr 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
47023 Issued in CA
Practice address
8471 Garden Grove Blvd.
Garden Grove, CA 92844
Phone
(714) 636-0200
Fax
(714) 530-3212
NPI assigned
Apr 6, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 47023 CA Primary

Addresses

Primary practice location

8471 Garden Grove Blvd.
Garden Grove, CA 92844

Mailing address

8471 Garden Grove Blvd.
Garden Grove, CA 92844
Phone (714) 636-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20160606001218 CA Order and Referring Only - DentistPractitioner - Dentist 8820388713

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
47023CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333670400000",
    "number": "1932465622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8471 GARDEN GROVE BLVD.",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "92844",
            "telephone_number": "714-636-0200",
            "fax_number": "714-530-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8471 GARDEN GROVE BLVD.",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "92844",
            "telephone_number": "714-636-0200",
            "fax_number": "714-530-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOO",
        "first_name": "DONG",
        "middle_name": "J.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-06",
        "last_updated": "2012-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "47023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.