John J Yae, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DE00006243 Issued in WA

Practice address

19720 68TH Ave W
Suite #a
Lynnwood, WA 98036-4568

Phone

(425) 776-9132

Fax

(425) 670-0568

NPI assigned

Sep 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Doosu Baik PLLC

  • Dental Clinic/Center
  • Lynnwood, WA
  • NPI 1992643811
  NPD (past)

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552003200000",
    "number": "1073500534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19720 68TH AVE W",
            "address_2": "SUITE #A",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364568",
            "telephone_number": "425-776-9132",
            "fax_number": "425-670-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19720 68TH AVE W",
            "address_2": "SUITE #A",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364568",
            "telephone_number": "425-776-9132",
            "fax_number": "425-670-0568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAE",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2019-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE00006243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Wenchen Hsiao Wu, DMD
• Wanting Wu, MFTA
• Carolyn Ann Wyckoff, LPN
• Alivia Ann Wynar
• Shengyi Your Saved Addresses Xian
• Fang Yang
• Hee-Jin Yang, DDS
• Joseph Yang
• Steve L. Yang, M.D.
• Virginia Campos Yanos, RN, MSN

• Oral and Maxillofacial Surgery (Dentist) in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2019; 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.