Provider Demographics
NPI:1447356480
Name:YOON, RICHARD S (DMD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:S
Last Name:YOON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:957 FAULKNER RD
Mailing Address - Street 2:#104
Mailing Address - City:SANTA PAULA
Mailing Address - State:CA
Mailing Address - Zip Code:93060-9124
Mailing Address - Country:US
Mailing Address - Phone:805-525-2223
Mailing Address - Fax:805-525-2288
Practice Address - Street 1:957 FAULKNER RD
Practice Address - Street 2:#104
Practice Address - City:SANTA PAULA
Practice Address - State:CA
Practice Address - Zip Code:93060-9124
Practice Address - Country:US
Practice Address - Phone:805-525-2223
Practice Address - Fax:805-525-2288
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA524871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice