Provider Demographics
NPI:1346339868
Name:YOON, KYUNG OK (DDS)
Entity type:Individual
Prefix:DR
First Name:KYUNG OK
Middle Name:
Last Name:YOON
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 1:11727 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-3939
Mailing Address - Country:US
Mailing Address - Phone:562-695-5112
Mailing Address - Fax:562-695-1802
Practice Address - Street 1:11727 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-3939
Practice Address - Country:US
Practice Address - Phone:562-695-5112
Practice Address - Fax:562-695-1802
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA432731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA15615-1OtherDENTAL BENEFIT PROVIDER(H
CA1897OtherHEALTH NET
CA97003101OtherSAFE GUARD
CA963778OtherUNITED CONCORDIA
CACA 7361OtherDENTAL MANAGEMENT ORG
CA13339OtherUNITED DENTAL CARE
CA556027OtherBLUE CROSS (HMO)
CAD43273OtherDENTI-CAL
CA43107OtherPACIFIC CARE
CA6917OtherPACIFIC UNION DENTAL
CA0002165OtherMANAGEM DENTAL GUARD
CA27132OtherAETNA(HMO)
CA904255OtherDELTA DENTAL HEALTHY FAMI
CADJ17OtherSMILE SAVER