Provider Demographics
NPI:1932465622
Name:YOO, DONG J (DDS)
Entity Type:Individual
Prefix:
First Name:DONG
Middle Name:J
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 1:8471 GARDEN GROVE BLVD.
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92844
Mailing Address - Country:US
Mailing Address - Phone:714-636-0200
Mailing Address - Fax:714-530-3212
Practice Address - Street 1:8471 GARDEN GROVE BLVD.
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844
Practice Address - Country:US
Practice Address - Phone:714-636-0200
Practice Address - Fax:714-530-3212
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47023122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist