Individual provider Active NPI

Hayeon Min, D.M.D.

  • Dentist
  • Edmonds, WA
National Provider Identifier
1205633716
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE70127710 Issued in WA
Practice address
23320 Highway 99
Edmonds, WA 98026-8744
Phone
(425) 640-5500
Fax
(425) 640-5534
NPI assigned
Mar 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE70127710 WA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

23320 Highway 99
Edmonds, WA 98026-8744

Mailing address

23320 Highway 99
Edmonds, WA 98026-8744
Phone (425) 640-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250905004059 WA Order and Referring Only - DentistPractitioner - Dentist 3173025418

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DR61679122WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1740960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1205633716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23320 HIGHWAY 99",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268744",
            "telephone_number": "425-640-5500",
            "fax_number": "425-640-5534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23320 HIGHWAY 99",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268744",
            "telephone_number": "425-640-5500",
            "fax_number": "425-640-5534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIN",
        "first_name": "HAYEON",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-03",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE70127710",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

Verify at the official NPI Registry.