DR. JAE YOUNG YOO (NPI# 1902314834) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902314834 |
| Entity Type | Individual |
| Full Name | DR. JAE YOUNG YOO |
| Other Name | DR. ETHAN JAE-YOUNG YOO |
| Credential | DDS, MSD |
| Practice Address |
4765 Carmel Mountain Rd Ste 208 San Diego CA 92130-6657 |
| Mailing Address |
404 Gateway Dr Apt 3 Pacifica CA 94044-1606 |
| Practice Telephone | 8582905278 |
| Mailing Telephone | 5105071134 |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2020-11-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
103617 | CA | Dental Providers |
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
00203357 | CO | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 18335 E 103rd Ave Unit 103, Commerce City, CO 800223103 | 3034980351 | |
| 605 Market St Ste 1200, San Francisco, CA 941053214 | 4156533087 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528356896 | Jae Eun Yoo | Nurse Practitioner | 225 Rector Pl Apt 8l, New York, NY 10280-1189 | 2011-07-20 |
| 1639545031 | Jae Yoo | Dentist | 408 Main St, Salinas, CA 93901-3306 | 2015-08-19 |
| 1295811966 | Jae Yong Yoo | Internal Medicine | 966 S Western Ave, Ste 208, Los Angeles, CA 90006-1016 | 2006-10-27 |
| 1225008311 | Jae Hong Yoo | Pathology | 3445 Executive Center Dr, Suite 250, Austin, TX 78731-1678 | 2006-01-23 |
| Street Address |
4765 CARMEL MOUNTAIN RD STE 208 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92130-6657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629692397 | Tlc Family Therapy | Marriage & Family Therapist | 5965 Village Way. Suite 105 #112, San Diego, CA 92130 | 2020-05-29 |
| 1447746169 | Jack Perlov | Psychiatry & Neurology | 3535 Caminito El Rincon, Unit 268, San Diego, CA 92130 | 2018-07-05 |
| 1326551003 | Theotokos, LLC | Pharmacy | 5550 Carmel Mountain Rd Ste 111, San Diego, CA 92130 | 2017-11-16 |
| 1154879146 | Halie Hommes | Occupational Therapist | 12250 El Camino Real Ste 250, San Diego, CA 92130 | 2016-09-19 |
| 1790232015 | Coastal Skin and Eye Institute, Inc. | Ophthalmology | 5550 Carmel Mountain Road, Suite 206, San Diego, CA 92130 | 2016-09-02 |
| 1720534951 | Nosti and Rygg Dental Corporation | Dentist | 5550 Carmel Mountain Road, Ste 200, San Diego, CA 92130 | 2016-08-28 |
| 1831644053 | Marco Savittieri | Dentist | 3715 Ruette De Vl, San Diego, CA 92130 | 2016-08-17 |
| 1336508621 | Discovery Practice Management, Inc | Psychiatric Residential Treatment Facility | 11455 Camino Real, Ste 360, San Diego, CA 92130 | 2016-02-16 |
| 1427434679 | Coast Pediatrics Carmel Valley | Pediatrics | 5965 Village Drive, Suite 201, San Diego, CA 92130 | 2015-08-10 |
| 1659753762 | T Sidal Dds Md Inc | Dentist | 12395 El Camino Real, Suite 304, Torrey Pines Oral & Maxillofacial Surgery, San Diego, CA 92130 | 2015-06-25 |
| Find all providers in zip 92130 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295210920 | Hiba Alabdullah | Dentist | 6482 Ambrosia Dr Apt 5106, San Diego, CA 92124-3143 | 2018-09-28 |
| 1548745300 | Cesar Augusto Manrique Moreno | Dentist | 1041 Market St Ste 165, San Diego, CA 92101-7233 | 2018-09-27 |
| 1003326224 | Dr. Hoss, A Professional Corporation | Dentist | 11943 El Camino Real Ste 200, San Diego, CA 92130-2597 | 2017-10-02 |
| 1336668110 | Hoss Km Dental Group, A Professional Group | Dentist | 9737 Aero Dr, San Diego, CA 92123-1859 | 2017-09-13 |
| 1790136687 | Cheryl Kang Guerrero | Dentist | 3810 Valley Centre Dr Ste 902a, San Diego, CA 92130-3308 | 2016-06-22 |
| 1457748212 | Peter Mark Vrontikis | Dentist | 7777 Westside Dr Apt 469, San Diego, CA 92108-1242 | 2015-04-20 |
| 1568857464 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 4074 Fairmount Avenue, Suite B, San Diego, CA 92105 | 2015-03-30 |
| 1649522913 | Budd Email Rubin | Dentist | 1145 Pacific Beach Dr, #408, San Diego, CA 92109-5194 | 2012-10-10 |
| 1700165917 | Matthew Durschlag | Dentist | 239 Laurel St Ste 201, San Diego, CA 92101-1473 | 2011-08-05 |
| 1144549833 | Brittany Koncz | Dentist | 9737 Aero Dr Ste 210, San Diego, CA 92123 | 2010-05-20 |
| Find all providers in SAN DIEGO | ||||
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| 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.