Individual provider Active NPI

Hyun Jin You

  • Denturist
  • Marysville, WA
National Provider Identifier
1124519103
Registry record updated May 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DenturistTaxonomy code 122400000X
License
DN60833142 Issued in WA
Practice address
1242 State Ave
Marysville, WA 98270-3672
Phone
(833) 900-1050
Fax
(909) 621-3125
NPI assigned
May 24, 2018
Last updated
May 24, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Denturist 122400000X DN60833142 WA Primary

Addresses

Primary practice location

1242 State Ave
Marysville, WA 98270-3672

Mailing address

9597 Central Ave
Montclair, CA 91763-2424
Phone (833) 900-1050

Other practice location 1

1251 Auburn Way N
Auburn, WA 98002-4148
Phone (833) 900-1050

Other identifiers 1

IdentifierTypeStateIssuer
DN60833142OtherWAWASHINGTON STATE DEPARTMENT OF HEALTH

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
DN60833142WAMDDenturist

Practice roles

OrganizationSpecialtyStatusNew patients
Smyle Denture Design Current Accepting new patients
The Smile Store, LLC Denturist Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558656000000",
    "number": "1124519103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9597 CENTRAL AVE",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632424",
            "telephone_number": "833-900-1050",
            "fax_number": "909-621-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1242 STATE AVE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982703672",
            "telephone_number": "833-900-1050",
            "fax_number": "909-621-3125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1251 Auburn Way N",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "WA",
            "postal_code": "980024148",
            "country_code": "US",
            "telephone_number": "833-900-1050",
            "fax_number": "909-621-3125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOU",
        "first_name": "HYUN",
        "middle_name": "JIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-24",
        "last_updated": "2019-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "",
            "desc": "Denturist",
            "state": "WA",
            "license": "DN60833142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE  DEPARTMENT OF HEALTH",
            "identifier": "DN60833142",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.