Provider Demographics
NPI:1497735377
Name:YOON, TONY KYUNGSIK (DDS)
Entity Type:Individual
Prefix:DR
First Name:TONY
Middle Name:KYUNGSIK
Last Name:YOON
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 1:70 THOMAS JOHNSON DR
Mailing Address - Street 2:SUITE 123
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4361
Mailing Address - Country:US
Mailing Address - Phone:301-668-3000
Mailing Address - Fax:
Practice Address - Street 1:70 THOMAS JOHNSON DR
Practice Address - Street 2:SUITE 123
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4361
Practice Address - Country:US
Practice Address - Phone:301-668-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD150881223E0200X
MADN1855596122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist