Provider Demographics
NPI:1215360458
Name:JONG SOON YOON DMD INC
Entity Type:Organization
Organization Name:JONG SOON YOON DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JONG SOON
Authorized Official - Middle Name:
Authorized Official - Last Name:YOON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:213-382-9800
Mailing Address - Street 1:500 S VIRGIL AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-1446
Mailing Address - Country:US
Mailing Address - Phone:213-382-9800
Mailing Address - Fax:213-382-9801
Practice Address - Street 1:500 S VIRGIL AVE STE 305
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1446
Practice Address - Country:US
Practice Address - Phone:213-382-9800
Practice Address - Fax:213-382-9801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA553891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty