Provider Demographics
NPI:1598804163
Name:YOON, SANG M (DDS, JD)
Entity type:Individual
Prefix:DR
First Name:SANG
Middle Name:M
Last Name:YOON
Suffix:
Gender:M
Credentials:DDS, JD
Other - Prefix:DR
Other - First Name:SANG
Other - Middle Name:M
Other - Last Name:YOON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DR YOON DDS, JD
Mailing Address - Street 1:72210 HIGHWAY 111 STE E-1
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-2782
Mailing Address - Country:US
Mailing Address - Phone:442-274-8123
Mailing Address - Fax:442-274-2011
Practice Address - Street 1:72210 HIGHWAY 111 STE E-1
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-2782
Practice Address - Country:US
Practice Address - Phone:442-274-8123
Practice Address - Fax:442-274-2011
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46348122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist