Minhyung Ji, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

105313 Issued in CA

Practice address

700 W 9TH St Apt 817
Los Angeles, CA 90015-4515

Phone

(617) 910-8856

NPI assigned

Jun 14, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Revere Dentistry and Braces LLC

  • General Practice Dentistry
  • Revere, MA
  • NPI 1154849198
  NPD (past)

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

{
    "created_epoch": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1336709104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W 9TH ST APT 817",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900154515",
            "telephone_number": "617-910-8856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W 9TH ST APT 817",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900154515",
            "telephone_number": "617-910-8856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JI",
        "first_name": "MINHYUNG",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-14",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "105313",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1858411",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Ji
• Jessica Ji
• Jiah Ji, L.AC
• Joanna Ji, MS
• Joonghwa Ji
• Sen Ji, MD
• Xinyu Ji, MD
• Yong Ji, MD
• Cassie Jia
• Wen Tao Jia

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.