Provider Demographics
NPI:1477700011
Name:YOON, ANNE JIYOUNG (DDS, MS ORTHODONTICS)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:JIYOUNG
Last Name:YOON
Suffix:
Gender:F
Credentials:DDS, MS ORTHODONTICS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3199 CLAY ST APT 5
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1650
Mailing Address - Country:US
Mailing Address - Phone:310-963-7087
Mailing Address - Fax:
Practice Address - Street 1:6851 AMADOR PLAZA RD
Practice Address - Street 2:(925) 560-9968
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2940
Practice Address - Country:US
Practice Address - Phone:925-560-9968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550811223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics