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General NPI Number Information
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NPI Number | 1669322244
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Entity Type | Organization
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Legal Business Name | FUN DENTAL 4 KIDS 6
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Dates
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Enumeration Date | 02/02/2026
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 2409 E 1ST ST
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City | LOS ANGELES
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State | CA
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Zip | 90033-3549
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Country | US
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Telephone | 310-363-5107
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Fax |
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Provider Business Mailing Address
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Address Line | 2409 E 1ST ST
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City | LOS ANGELES
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State | CA
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Zip | 90033-3549
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | JOHN YOO
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Credential | DDS
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Telephone | 310-619-5880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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