Ji Yeon Chung, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE61555282 Issued in WA

Practice address

1030 Outlet Collection Way SW
Auburn, WA 98001-6537

Phone

(253) 638-4860

NPI assigned

Nov 22, 2024

Last updated

Nov 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1732233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1114742277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 121ST AVE NE APT 223",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980055069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 OUTLET COLLECTION WAY SW",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980016537",
            "telephone_number": "253-638-4860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "JI YEON",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-22",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61555282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hyun Hyo Choi, DDS
• John Choi I, DN60731854
• Michael H Chow, O.D.
• Brady Glenn Christoph, DPT
• Joelle Wisteria Chu
• Circle Creek Therapy PLLC (Circle Creek Therapy)
• City of Auburn
• Susan Caroline Clabots-Sheets, RN ARNP FNP-BC
• D'Lexus Clark
• Jessica Clark

• General Practice Dentistry in Auburn, WA
• Providers in Auburn, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.