Individual provider Active NPI

Keusung Yun, DDS

  • General Practice Dentistry
  • Harrisonburg, VA
National Provider Identifier
1033499405
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401415373 Issued in VA
Practice address
2262 Blue Stone Hills Dr Ste a
Harrisonburg, VA 22801-5434
Phone
(540) 433-3080
NPI assigned
Aug 17, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401415373 VA Primary

Addresses

Primary practice location

2262 Blue Stone Hills Dr Ste a
Harrisonburg, VA 22801-5434

Mailing address

31 Bogey Ave
New Market, VA 22844-9667
Phone (918) 710-5526

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401415373VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Keusung Yun Dental P.C. CurrentSince Jul 24, 2022 Accepting new patients

Locations

2262 Blue Stone Hills Dr
Ste A
Harrisonburg, VA 22801
Phone (540) 433-3080

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1033499405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 BOGEY AVE",
            "city": "NEW MARKET",
            "state": "VA",
            "postal_code": "228449667",
            "telephone_number": "918-710-5526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2262 BLUE STONE HILLS DR STE A",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228015434",
            "telephone_number": "540-433-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUN",
        "first_name": "KEUSUNG",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401415373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisonburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.