Active NPI
Jung S Yun, DDS
- Dentist
- Lombard, IL
National Provider Identifier
1013125822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019-21660
- Practice address
- 929 S Main St
Suite 110
Lombard, IL 60148-3364 - Phone
- (630) 620-5888
- Fax
- (630) 620-6149
- NPI assigned
- May 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019-21660 | IL | Primary |
Addresses
Primary practice location
929 S Main St
Suite 110
Lombard, IL 60148-3364
Mailing address
929 S Main St
Suite 110
Lombard, IL 60148-3364
Phone (630) 620-5888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160520001362 | IL | Order and Referring Only - Other (Physician) | 3072802644 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019-21660 | IL | MD | Dentist |
Networks
- devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
- IL HMO C-SNP
- devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013125822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "929 S MAIN ST",
"address_2": "SUITE 110",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601483364",
"telephone_number": "630-620-5888",
"fax_number": "630-620-6149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "929 S MAIN ST",
"address_2": "SUITE 110",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601483364",
"telephone_number": "630-620-5888",
"fax_number": "630-620-6149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YUN",
"first_name": "JUNG",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019-21660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lombard, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.