Individual provider Active NPI

Yong Joon Coe, DDS,MSD,MS

  • Prosthodontics
  • Leesburg, VA
National Provider Identifier
1184784274
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
0401412988 Issued in VA
Practice address
19490 Sandridge Way Ste 160
Leesburg, VA 20176-3469
Phone
(703) 454-5656
Fax
(703) 454-5056
NPI assigned
Dec 11, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401412988 VA
Dentist 122300000X 40091 IA
Prosthodontics 1223P0700X 40091 IA
Prosthodontics 1223P0700X 0401412988 VA Primary

Addresses

Primary practice location

19490 Sandridge Way Ste 160
Leesburg, VA 20176-3469

Mailing address

19490 Sandridge Way Ste 160
Leesburg, VA 20176-3469
Phone (703) 454-5656

Other names 1

  • Dr. Yong Joon Ko Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
40091IAMDDentist
0401412988VAMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Architectura Dental PLLC CurrentSince Jul 24, 2022 Accepting new patients

Locations

19490 Sandridge Way
Ste 160
Leesburg, VA 20176
Phone (703) 454-5656

Organizations & group practices 1

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1184784274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19490 SANDRIDGE WAY STE 160",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201763469",
            "telephone_number": "703-454-5656",
            "fax_number": "703-454-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19490 SANDRIDGE WAY STE 160",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201763469",
            "telephone_number": "703-454-5656",
            "fax_number": "703-454-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COE",
        "first_name": "YONG",
        "middle_name": "JOON",
        "name_prefix": "Dr.",
        "credential": "DDS,MSD,MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401412988",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "40091",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "IA",
            "license": "40091",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "VA",
            "license": "0401412988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YONG JOON",
            "last_name": "KO",
            "prefix": "DR.",
            "credential": "DDS,MSD,MS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.