=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790130821
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | QUINN YOST DDS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/26/2016
-----------------------------------------------------
Last Update Date | 02/19/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1115 AVIATION BLVD
-----------------------------------------------------
City | HERMOSA BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90254-4027
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 424-254-0705
-----------------------------------------------------
Fax | 424-254-0711
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1115 AVIATION BLVD
-----------------------------------------------------
City | HERMOSA BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90254-4027
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 424-254-0705
-----------------------------------------------------
Fax | 424-254-0711
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 60656563
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1223P0221X
-----------------------------------------------------
Taxonomy Name | Pediatric Dentistry
-----------------------------------------------------
License Number | DDS102682
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | DDS102682
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------