Provider Demographics
NPI:1497905475
Name:YOO, BYUNG SUN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BYUNG
Middle Name:SUN
Last Name:YOO
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 1:2425 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-1515
Mailing Address - Country:US
Mailing Address - Phone:619-231-1624
Mailing Address - Fax:619-231-4455
Practice Address - Street 1:2425 3RD AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-1515
Practice Address - Country:US
Practice Address - Phone:619-231-1624
Practice Address - Fax:619-231-4455
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43511122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist