Individual provider Active NPI

Soo Kyo Yoon, DDS

  • General Practice Dentistry
  • Bristow, VA
National Provider Identifier
1124374038
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401416437 Issued in VA
Practice address
10322 Bristow Station Dr Ste 109
Bristow, VA 20136-1435
Phone
(703) 596-9290
NPI assigned
Jul 28, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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 0401416437 VA Primary

Addresses

Primary practice location

10322 Bristow Station Dr Ste 109
Bristow, VA 20136-1435

Mailing address

10322 Bristow Station Dr Ste 109
Bristow, VA 20136-1435
Phone (703) 596-9290

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
0401416437VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Yoon and Yoon Dentistry PLLC General Practice Current Accepting new patients

Locations

10322 Bristow Station Dr
Ste 109
Bristow, VA 20136
Phone (703) 596-9290

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": "1343433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1124374038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10322 BRISTOW STATION DR STE 109",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201361435",
            "telephone_number": "703-596-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10322 BRISTOW STATION DR STE 109",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201361435",
            "telephone_number": "703-596-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOON",
        "first_name": "SOO KYO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-28",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401416437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristow, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; 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.