Evergreen Prosthodontic Associates, LLC
NPI 1306277892ActiveOrganization· Dentist, Prosthodontics· Fairfield, CT
Dentist, Prosthodontics in Fairfield, Connecticut, registered in NPPES in December 2013, part of Evergreen Prosrthodontic Associates, LLC. The authorized official on file is Minsung Yoon, DDS, Owner.
Overview
| NPI | 1306277892 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Evergreen Prosrthodontic Associates, LLC |
| NPI issued | Dec 9, 2013 |
| Last updated in NPPES | Mar 30, 2023 |
| Certified by provider | Mar 30, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Prosthodontics Primary | 1223P0700X | — | — |
| Dentist, Prosthodontics | 1223P0700X | 9601 | CT |
| Dentist, Prosthodontics | 1223P0700X | 9863 | CT |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Dentist, Prosthodontics providers in Fairfield
- 1295954469
- 1619997004
- 1366651663
- 1588058077
- 1093877946