Provider Demographics
NPI:1558896068
Name:YOO, JINYOUNG ANNY (DDS)
Entity Type:Individual
Prefix:
First Name:JINYOUNG
Middle Name:ANNY
Last Name:YOO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 PATRIOT BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8087
Mailing Address - Country:US
Mailing Address - Phone:847-440-3331
Mailing Address - Fax:
Practice Address - Street 1:2640 PATRIOT BLVD STE 250
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-8087
Practice Address - Country:US
Practice Address - Phone:847-440-3331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-22
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0323861223G0001X
CADDS1030261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice