Healthcare Provider Details

I. General information

NPI: 1407418940
Provider Name (Legal Business Name): BYUNG UN YOO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2019
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 S BEACH BLVD STE D
ANAHEIM CA
92804-1812
US

IV. Provider business mailing address

515 S BEACH BLVD STE D
ANAHEIM CA
92804-1812
US

V. Phone/Fax

Practice location:
  • Phone: 714-828-6500
  • Fax: 714-828-6500
Mailing address:
  • Phone: 714-828-6500
  • Fax: 714-828-4365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number112176
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: