Active NPI
Jay Yun
- General Practice Dentistry
- Tucson, AZ
National Provider Identifier
1124702550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D011880
- Practice address
- 2990 S 6TH Ave
Tucson, AZ 85713-4705 - Phone
- (520) 526-0578
- NPI assigned
- Jun 14, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D011880 | AZ | Primary |
Addresses
Primary practice location
2990 S 6TH Ave
Tucson, AZ 85713-4705
Mailing address
2161 S Finley Rd Apt 804
Lombard, IL 60148-6471
Phone (425) 577-9805
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251008003034 | AZ | Order and Referring Only - Dentist | 5092212787 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688342400000",
"number": "1124702550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2161 S FINLEY RD APT 804",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601486471",
"telephone_number": "425-577-9805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2990 S 6TH AVE",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857134705",
"telephone_number": "520-526-0578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YUN",
"first_name": "JAY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-06-14",
"last_updated": "2023-07-03",
"certification_date": "2023-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "D011880",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.