Active NPI
Hayeon Min, D.M.D.
- Dentist
- Edmonds, WA
National Provider Identifier
1205633716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE70127710
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250905004059 | WA | Order and Referring Only - Dentist | 3173025418 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR61679122 | WA | MD | Dentist |
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.