MEDICARE: DR. QUINN YOST DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	60656563	WA
2	1223P0221X	Pediatric Dentistry	DDS102682	CA
3	122300000X	Dentist	DDS102682	CA

General Provider Information

NPI Number	:	1790130821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. QUINN YOST DDS

Provider Business Mailing Address
First Line	:	1115 AVIATION BLVD
Second Line	:
City	:	HERMOSA BEACH
State	:	CA
Zip	:	90254-4027
Country	:	US
Telephone Number	:	424-254-0705
Fax Number	:	424-254-0711

Provider Business Practice Location Address
First Line	:	1115 AVIATION BLVD
Second Line	:
City	:	HERMOSA BEACH
State	:	CA
Zip	:	90254-4027
Country	:	US
Telephone Number	:	424-254-0705
Fax Number	:	424-254-0711

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2016
Last Update Date	:	02/19/2026

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