Individual provider Active NPI

Yena Jun, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • New York, NY
National Provider Identifier
1194313692
Registry record updated Jan 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
061091 Issued in NY
Practice address
130 W 86TH St Ofc 1a
New York, NY 10024-4066
Phone
(212) 362-3355
NPI assigned
Jan 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 061091 NY Primary

Addresses

Primary practice location

130 W 86TH St Ofc 1a
New York, NY 10024-4066

Mailing address

130 W 86TH St Ofc 1a
New York, NY 10024-4066

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
061091NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1610236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610236800000",
    "number": "1194313692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 W 86TH ST OFC 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100244066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W 86TH ST OFC 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100244066",
            "telephone_number": "212-362-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUN",
        "first_name": "YENA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-10",
        "last_updated": "2021-01-10",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "061091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2021; 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.