Provider Demographics
NPI:1376674309
Name:PYON, SCOTT SANGMIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:SANGMIN
Last Name:PYON
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 1:405 CAMBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1614
Mailing Address - Country:US
Mailing Address - Phone:650-326-6384
Mailing Address - Fax:
Practice Address - Street 1:405 CAMBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1614
Practice Address - Country:US
Practice Address - Phone:650-326-6384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48665122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist