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General NPI Number Information
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NPI Number | 1235829169
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Entity Type | Individual
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Provider Name | BRIAN YOON
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Gender | Male
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Dates
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Enumeration Date | 05/12/2023
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 10525 S EASTERN AVE STE 100
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City | HENDERSON
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State | NV
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Zip | 89052-3971
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Country | US
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Telephone | 702-508-0906
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Fax |
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Provider Business Mailing Address
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Address Line | 10000 S MARYLAND PKWY APT 1169
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City | LAS VEGAS
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State | NV
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Zip | 89183-6388
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Country | US
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Telephone | 443-694-1216
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7908
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License Number State | NV
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