Individual provider Active NPI

Jeannie S Yoon, D.D.S.

  • General Practice Dentistry
  • Great Falls, MT
National Provider Identifier
1154684686
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
26153 Issued in MT
Practice address
425 Smelter Ave NE
Great Falls, MT 59404-1927
Phone
(406) 247-7130
NPI assigned
Jun 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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 26153 MT Primary

Addresses

Primary practice location

425 Smelter Ave NE
Great Falls, MT 59404-1927

Mailing address

425 Smelter Ave NE
Great Falls, MT 59404-1927
Phone (406) 247-7130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20251114001962 MT Practitioner - Dentist 3678889169
I20260224002111 TX Practitioner - Dentist 3678889169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
University of Maryland at Baltimore School of Dentistry, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

260 18TH Ave NW
Great Falls, MT 59404-1810

511 Central Ave W
Great Falls, MT 59404-2848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26153MTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
US Dept of Health & Human Services-Division of Indian Health Current Accepting new patients
Little Shell Health Center Current Accepting new patients
Little Shell Tribe of Chippewa Indians of Montana PastSince Sep 3, 2025 Accepting new patients

Locations

425 Smelter Ave NE
Great Falls, MT 59404
Phone (406) 247-7130

Organizations & group practices 4

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": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1154684686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 SMELTER AVE NE",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594041927",
            "telephone_number": "406-247-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 SMELTER AVE NE",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594041927",
            "telephone_number": "406-247-7130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOON",
        "first_name": "JEANNIE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "26153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

Verify at the official NPI Registry.