Individual provider Active NPI

Hyun J Yoon, DMD

  • Dentist
  • Salem, OR
National Provider Identifier
1275910176
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D11434 Issued in OR
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

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
D11434ORMDDentist
31317TXMDGeneral 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.

Verify at the official NPI Registry.