Active NPI
Hyun J Yoon, DMD
- Dentist
- Salem, OR
National Provider Identifier
1275910176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D11434
- Practice address
- 2045 Madrona Ave SE # 150
Salem, OR 97302-1149 - Phone
- (503) 809-4784
- NPI assigned
- Apr 29, 2015
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 31317 | TX | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | D11434 | OR | Primary |
Addresses
Primary practice location
2045 Madrona Ave SE # 150
Salem, OR 97302-1149
Mailing address
3833 S Bond Ave Apt 139
Portland, OR 97239-4739
Phone (217) 853-3055
Other practice location 1
PSC 3 Box 841
Apo, AP 96266-0009
Phone (315) 784-9095
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 |
|---|---|---|---|
| D11434 | OR | MD | Dentist |
| 31317 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664841600000",
"number": "1275910176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3833 S BOND AVE APT 139",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394739",
"telephone_number": "217-853-3055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2045 MADRONA AVE SE # 150",
"city": "SALEM",
"state": "OR",
"postal_code": "973021149",
"telephone_number": "503-809-4784"
}
],
"practiceLocations": [
{
"address_1": "PSC 3 Box 841",
"address_purpose": "LOCATION",
"city": "APO",
"state": "AP",
"postal_code": "962660009",
"country_code": "US",
"telephone_number": "315-784-9095",
"country_name": "United States",
"address_type": "MIL"
}
],
"basic": {
"last_name": "YOON",
"first_name": "HYUN",
"middle_name": "J",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-29",
"last_updated": "2022-10-04",
"certification_date": "2022-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "31317",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D11434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.