Y JUN DENTAL CORP (NPI# 1215409479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215409479 |
| Entity Type | Organization |
| Organization Name | Y JUN DENTAL CORP |
| Other Organization Name | SURF CITY ORAL & MAXILLOFACIAL SURGERY |
| Practice Address |
17822 Beach Blvd Ste 342 Huntington Beach CA 92647-7518 |
| Practice Telephone | 7148476044 |
| Mailing Telephone | 7148476044 |
| Enumeration Date | 2018-12-27 |
| Last Update Date | 2019-01-05 |
| Authorized Official Name | DR. YOUNG JUN (PRESIDENT) |
| Authorized Official Telephone | 7148476044 |
| Authorized Official Credential | DDS, MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DR. GARY CARLSEN | 1568527703 | 01 |
| CA | DR. MARC TOSO | 1932496809 | 01 |
| Other Name | Type Code |
|---|---|
| Surf City Oral & Maxillofacial Surgery | Doing Business As Name - Organization |
| Street Address |
17822 BEACH BLVD STE 342 |
| City | HUNTINGTON BEACH |
| State | CA |
| Zip Code | 92647-7518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568527703 | Gary David Carlsen | Dentist | 17822 Beach Blvd Ste 342, Huntington Beach, CA 92647-7518 | 2006-12-27 |
| 1104245976 | Omid Niavarani | Dentist | 17822 Beach Blvd Ste 342, Huntington Beach, CA 92647-7518 | 2014-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417464231 | Patricia Michelle Ramsey | Counselor | 16761 Viewpoint Lane, Apt 386, Huntington Beach, CA 92647 | 2018-01-02 |
| 1780103390 | Luz Flores | Health Educator | 8041 Newman Avenue, Hungtington Beach, CA 92647 | 2017-09-14 |
| 1134649106 | Louise Polzel | Social Worker | 17111 Beach Blvd St 205, Huntington Beach, CA 92647 | 2017-06-21 |
| 1205364015 | Chi Hong Nguyen | Family Medicine | 8201 Newman Ave 101, Huntington, CA 92647 | 2017-05-24 |
| 1396281770 | Sandra Vera | Specialist/Technologist | 7812 Edinger Ave. #400, Huntington Beach, CA 92647 | 2017-01-10 |
| 1245773050 | Sherika Benjamin | Technician, Pathology | 8211 San Angelo Drive Suit #f2, Huntington Beach, CA 92647 | 2016-11-28 |
| 1306389440 | Nhi Pham Nguyen | Behavioral Analyst | 17732 Beach Blvd., Suite G, Huntington Beach, CA 92647 | 2016-11-21 |
| 1710345095 | Pacific Beach Medical Group, Inc. | Internal Medicine | 16111 Beach Blvd., Huntington Beach, CA 92647 | 2016-02-02 |
| 1699148494 | Daniel Bui | Dentist | 16900-a Goldenwest St, Huntington Beach, CA 92647 | 2015-11-03 |
| 1598132359 | Hayley Patricia Buchanan | Specialist/Technologist | 23441 S. Pointe Drive, Suite 245, Laguna Hills, ORANGE COUNTY 92647 | 2015-08-27 |
| Find all providers in zip 92647 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235426149 | Alan Shaw | Dentist | 18800 Main St Ste 205, Huntington Beach, CA 92648-1718 | 2011-06-30 |
| 1477849511 | Scott M Peifer | Dentist | 7891 Talbert Ave Ste 101, Huntington Beach, CA 92648-8613 | 2011-06-28 |
| 1558537498 | Solomon Poyourow | Dentist | 8292 Delfino Cir, Huntington Beach, CA 92646-1605 | 2008-04-30 |
| 1871704361 | Simona C Arcan | Dentist | 16511 Goldenwest St Ste 109, Huntington Beach, CA 92647-4484 | 2007-05-25 |
| 1568527703 | Gary David Carlsen | Dentist | 17822 Beach Blvd Ste 342, Huntington Beach, CA 92647-7518 | 2006-12-27 |
| 1821068644 | Donald Testa | Dentist | 3552 Runningtide Cir, Huntington Beach, CA 92649-2514 | 2006-01-24 |
| 1831796820 | Scott Peifer Dds, PC | Dentist | 7891 Talbert Ave Ste 101, Huntington Beach, CA 92648-8613 | 2020-10-03 |
| 1881109551 | Tuan Manh Hoang Dds Inc | Dentist | 19059 Bushard St, Huntington Beach, CA 92646-2431 | 2017-12-04 |
| 1104245976 | Omid Niavarani | Dentist | 17822 Beach Blvd Ste 342, Huntington Beach, CA 92647-7518 | 2014-04-09 |
| 1437456670 | Rick J. Berrios, Dds, Inc. | Dentist | 18800 Main St, Suite 205, Huntington Beach, CA 92648-1707 | 2011-02-24 |
| Find all providers in HUNTINGTON BEACH | ||||
| City | HUNTINGTON BEACH |
| Zip Code | 92647 |
Please comment or provide details below to improve the information on Y JUN DENTAL CORP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.