Healthcare Provider Details

I. General information

NPI: 1992172084
Provider Name (Legal Business Name): DR. JOOWON YOON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2015
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11934 HAWTHORNE BLVD SUITE B.
HAWTHRONE CA
90250
US

IV. Provider business mailing address

11934 HAWTHORNE BLVD SUITE B.
HAWTHRONE CA
90250
US

V. Phone/Fax

Practice location:
  • Phone: 424-348-2234
  • Fax: 844-742-0896
Mailing address:
  • Phone: 424-348-2234
  • Fax: 844-742-0896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number64779
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: