Healthcare Provider Details

I. General information

NPI: 1154239119
Provider Name (Legal Business Name): ANDREW YOO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59 DAMONTE RANCH PKWY STE F
RENO NV
89521-2989
US

IV. Provider business mailing address

9200 DOUBLE R BLVD UNIT 4091
RENO NV
89521-9030
US

V. Phone/Fax

Practice location:
  • Phone: 775-851-2204
  • Fax:
Mailing address:
  • Phone: 415-867-2735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8492
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: