Provider Demographics
NPI:1194959841
Name:YOON, JOHN K (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:K
Last Name:YOON
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 1:344 WILSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-5370
Mailing Address - Country:US
Mailing Address - Phone:407-679-0051
Mailing Address - Fax:407-679-0180
Practice Address - Street 1:344 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-5370
Practice Address - Country:US
Practice Address - Phone:407-679-0051
Practice Address - Fax:407-679-0180
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 132041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice