Individual provider Active NPI

Jiho Yun

  • General Practice Dentistry
  • McHenry, IL
National Provider Identifier
1184486953
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019034686 Issued in IL
Practice address
727 Ridgeview Dr
McHenry, IL 60050-7054
Phone
(815) 847-9292
NPI assigned
Jan 26, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 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 019034686 IL Primary

Addresses

Primary practice location

727 Ridgeview Dr
McHenry, IL 60050-7054

Mailing address

1443 W Rue Paris PL
Inverness, IL 60067-1225
Phone (773) 766-7546

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
019034686ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1706227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1184486953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1443 W RUE PARIS PL",
            "city": "INVERNESS",
            "state": "IL",
            "postal_code": "600671225",
            "telephone_number": "773-766-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 RIDGEVIEW DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600507054",
            "telephone_number": "815-847-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUN",
        "first_name": "JIHO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-26",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019034686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; 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.