Provider Demographics
NPI:1255687612
Name:YOON, ANDY S (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDY
Middle Name:S
Last Name:YOON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11033 ROSECRANS AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-3663
Mailing Address - Country:US
Mailing Address - Phone:562-929-3083
Mailing Address - Fax:562-278-0320
Practice Address - Street 1:11033 ROSECRANS AVE
Practice Address - Street 2:SUITE D
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-3663
Practice Address - Country:US
Practice Address - Phone:562-929-3083
Practice Address - Fax:562-278-0320
Is Sole Proprietor?:No
Enumeration Date:2012-08-02
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA427171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice