Active NPI
Christina Dahee Jeong, DE60762062
- Dentist
- Federal Way, WA
National Provider Identifier
1205357290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE60762062
- Practice address
- 33505 Pacific Hwy S
Federal Way, WA 98003-6809 - Phone
- (253) 815-8500
- NPI assigned
- Jun 29, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE60762062 | WA | Primary |
Addresses
Primary practice location
33505 Pacific Hwy S
Federal Way, WA 98003-6809
Mailing address
1635 SW 330TH PL
Federal Way, WA 98023-6432
Phone (253) 332-8055
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
| License | State | Type | Specialty |
|---|---|---|---|
| DE60762062 | WA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Dental & Denture Clinic,Inc | Past | Accepting new patients | |
| Y M Lee DDS PLLC | Dentist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dental Clinic/Center
- Federal Way, WA
- NPI 1619411568
-
- Dentist
- Federal Way, WA
- NPI 1538833579
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498694400000",
"number": "1205357290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1635 SW 330TH PL",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980236432",
"telephone_number": "253-332-8055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33505 PACIFIC HWY S",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980036809",
"telephone_number": "253-815-8500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEONG",
"first_name": "CHRISTINA",
"middle_name": "DAHEE",
"credential": "DE60762062",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-29",
"last_updated": "2017-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE60762062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Federal Way, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.