Individual provider Active NPI

Jae H Yoon, D.D.S.

  • Dentist
  • Texarkana, TX
National Provider Identifier
1336586460
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
32782 Issued in TX
Practice address
2700 Richmond Rd Ste 21
Texarkana, TX 75503-2340
Phone
(903) 223-0575
NPI assigned
May 30, 2013
Last updated
Nov 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN.00206402 CO
Dentist 122300000X 32782 TX Primary

Addresses

Primary practice location

2700 Richmond Rd Ste 21
Texarkana, TX 75503-2340

Mailing address

2700 Richmond Rd Ste 21
Texarkana, TX 75503-2340

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
DEN.00206402COMDDentist
32782TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Affordable Dentures & Implants - Texas Xiii, PLLC General Practice CurrentSince Nov 24, 2025 Accepting new patients
McCarthy Dentistry LLC Dentist Past Accepting new patients
McCarthy Dentistry LLC General Practice Past Accepting new patients
Jeffrey L. Martin DDS,P.a. Dentist PastSince Nov 24, 2025 Accepting new patients

Locations

2700 Richmond Rd
Ste 21
Texarkana, TX 75503
Phone (903) 223-0575

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1336586460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 RICHMOND RD STE 21",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 RICHMOND RD STE 21",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032340",
            "telephone_number": "903-223-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOON",
        "first_name": "JAE",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-30",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00206402",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "32782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; 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.