Provider Demographics
NPI:1780916833
Name:YUN, KENNETH S (MD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:S
Last Name:YUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10350 E DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2045 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5437
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-31
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7514208800000X
TXBP20022571208800000X
WI4935208800000X
CODR.0053210208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX280602801Medicaid
TX280602802Medicaid
TX1780916833OtherBLUE CROSS BLUE SHIELD
TXP01062993OtherRAILROAD MEDICARE
CO01952781Medicaid
CO024075OtherKAISER COMMERCIAL NUMBER
TX280602801Medicaid
TXTXB110955Medicare PIN
CO330713YK5YMedicare PIN