Provider Demographics
NPI:1134291313
Name:YOO, JEFF BYUNGCHUL (DDS)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:BYUNGCHUL
Last Name:YOO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11660 SOUTH ST STE 108
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-6609
Mailing Address - Country:US
Mailing Address - Phone:562-402-8166
Mailing Address - Fax:562-402-8256
Practice Address - Street 1:11660 SOUTH ST STE 108
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-6609
Practice Address - Country:US
Practice Address - Phone:562-402-8166
Practice Address - Fax:562-402-8256
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47213122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist