Basic Information
Provider Information
NPI: 1578763306
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YOON
FirstName: SARAH
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential: DDS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1430 TRUXTUN AVE
Address2: STE 400
City: BAKERSFIELD
State: CA
PostalCode: 933015246
CountryCode: US
TelephoneNumber: 6616353050
FaxNumber: 6618691503
Practice Location
Address1: 8787 HALL RD
Address2:  
City: LAMONT
State: CA
PostalCode: 932411953
CountryCode: US
TelephoneNumber: 6618453688
FaxNumber: 6618453739
Other Information
ProviderEnumerationDate: 07/19/2007
LastUpdateDate: 07/19/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000X55897CAY Dental ProvidersDentist 

No ID Information.


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