Active NPI
Jacqueline Yip, DMD
- Pediatric Dentistry
- Boynton Beach, FL
National Provider Identifier
1336767029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DN27688
- Practice address
- 391 N Congress Ave
Boynton Beach, FL 33426-3415 - Phone
- (561) 336-6560
- NPI assigned
- Jul 8, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | DS042800 | PA | |
| Dentist | 122300000X | 0442000420 | VA | |
| Pediatric Dentistry | 1223P0221X | DN27688 | FL | Primary |
Addresses
Primary practice location
391 N Congress Ave
Boynton Beach, FL 33426-3415
Mailing address
22714 Aspect Dr Apt 301
Boca Raton, FL 33428-3659
Other practice location 1
6900 Forest Ave Ste 110
Richmond, VA 23230-1730
Phone (804) 893-8715
Other practice location 2
2107B Cottman Ave
Philadelphia, PA 19149-1122
Phone (215) 235-4060
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 |
|---|---|---|---|
| 0442000420 | VA | MD | Dentist |
| DS042800 | PA | MD | General Practice Dentistry |
| DN27688 | FL | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689724800000",
"number": "1336767029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22714 ASPECT DR APT 301",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334283659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "391 N CONGRESS AVE",
"city": "BOYNTON BEACH",
"state": "FL",
"postal_code": "334263415",
"telephone_number": "561-336-6560"
}
],
"practiceLocations": [
{
"address_1": "6900 Forest Ave Ste 110",
"address_purpose": "LOCATION",
"city": "Richmond",
"state": "VA",
"postal_code": "232301730",
"country_code": "US",
"telephone_number": "804-893-8715",
"fax_number": "804-285-1292",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2107B Cottman Ave",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191491122",
"country_code": "US",
"telephone_number": "215-235-4060",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YIP",
"first_name": "JACQUELINE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-08",
"last_updated": "2023-07-19",
"certification_date": "2023-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS042800",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0442000420",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "FL",
"license": "DN27688",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boynton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.