Provider Demographics
NPI:1770112419
Name:WINEGAR, CONNIE YOON (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:CONNIE
Middle Name:YOON
Last Name:WINEGAR
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:DR
Other - First Name:CONNIE
Other - Middle Name:
Other - Last Name:YOON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:513 SEMINOLE RD
Mailing Address - Street 2:
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49444-3719
Mailing Address - Country:US
Mailing Address - Phone:231-733-9676
Mailing Address - Fax:
Practice Address - Street 1:513 SEMINOLE RD
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49444-3719
Practice Address - Country:US
Practice Address - Phone:231-733-9676
Practice Address - Fax:231-733-0868
Is Sole Proprietor?:No
Enumeration Date:2020-04-04
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016020671223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics