Provider Demographics
NPI:1730263062
Name:YOONG, BENEDICT IVAN (DDS)
Entity type:Individual
Prefix:DR
First Name:BENEDICT
Middle Name:IVAN
Last Name:YOONG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 TELEGRAPH RD STE 101
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-4251
Mailing Address - Country:US
Mailing Address - Phone:805-677-7703
Mailing Address - Fax:805-650-3468
Practice Address - Street 1:5500 TELEGRAPH RD STE 101
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-4251
Practice Address - Country:US
Practice Address - Phone:805-677-7703
Practice Address - Fax:805-650-3468
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47830122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist