Provider Demographics
NPI:1811919145
Name:YOON, KYLE JOON (DDS)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:JOON
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 1:9101 FRANKLIN SQUARE DR 315
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3969
Mailing Address - Country:US
Mailing Address - Phone:410-574-4616
Mailing Address - Fax:
Practice Address - Street 1:9101 FRANKLIN SQUARE DR
Practice Address - Street 2:STE 315
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3936
Practice Address - Country:US
Practice Address - Phone:410-529-1401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2016-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD139231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice