Basic Information
| Provider Information | |||||||||
| NPI: | 1659965309 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YOON | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | JIHUN | ||||||||
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| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7521 EDINGER AVE UNIT 4626 | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926470616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2144226715 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7903 ATLANTIC AVE STE G | ||||||||
| Address2: | |||||||||
| City: | CUDAHY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902015926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3237732200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2021 | ||||||||
| LastUpdateDate: | 02/23/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 105950 | CA | Y | Dental Providers | Dentist |
No ID Information.