NPIMap

Organization Active NPI

Jeeyup Dental PC

  • General Practice Dentistry
  • Sunnyside, NY
National Provider Identifier
1174830566
Registry record updated Feb 18, 2015
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
054395 Issued in NY
Legal business name
JEEYUP DENTAL PC
Practice address
3931 47TH Ave
Sunnyside, NY 11104-3576
Phone
(718) 392-3634
NPI assigned
Sep 7, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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

Authorized official

Name
Dr. Jee Yup Kim, DDSNPI 1831350222
Title
President
Phone
(718) 392-3634

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 054395 NY Primary

Addresses

Primary practice location

3931 47TH Ave
Sunnyside, NY 11104-3576

Mailing address

13702 Northern Blvd Apt 3B
Flushing, NY 11354-4173

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424217600000",
    "number": "1174830566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13702 NORTHERN BLVD APT 3B",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3931 47TH AVE",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111043576",
            "telephone_number": "718-392-3634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEEYUP DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-07",
        "last_updated": "2015-02-18",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JEE YUP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-392-3634",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "054395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; 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.