Individual provider Active NPI

Jin Yoo, DDS

  • Dentist
  • Honolulu, HI
National Provider Identifier
1942641113
Registry record updated Nov 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DT2537 Issued in HI
Practice address
850 W Hind Dr Ste 115
Honolulu, HI 96821
Phone
(808) 888-9563
NPI assigned
Jul 16, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DT2537 HI Primary

Addresses

Primary practice location

850 W Hind Dr Ste 115
Honolulu, HI 96821

Mailing address

850 W Hind Dr Ste 115
Honolulu, HI 96821-1845
Phone (808) 373-1050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20150917002759 HI Order and Referring Only - DentistPractitioner - Dentist 5193032423

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DT2537HIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Aina Haina Family Dental 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.

NPI Registry JSON

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

{
    "created_epoch": "1373932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541721600000",
    "number": "1942641113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W HIND DR STE 115",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968211845",
            "telephone_number": "808-373-1050",
            "fax_number": "808-373-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W HIND DR STE 115",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96821",
            "telephone_number": "808-888-9563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOO",
        "first_name": "JIN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-16",
        "last_updated": "2018-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "HI",
            "license": "DT2537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.