Individual provider Active NPI

Jae S Yoon, DDS

  • Dentist
  • Fairfax, VA
National Provider Identifier
1346417474
Registry record updated May 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401007786 Issued in VA
Practice address
8316 Arlington Blvd
Suie 218
Fairfax, VA 22031-5207
Phone
(703) 207-9077
Fax
(703) 207-9079
NPI assigned
May 8, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401007786 VA Primary

Addresses

Primary practice location

8316 Arlington Blvd
Suie 218
Fairfax, VA 22031-5207

Mailing address

8316 Arlington Blvd
Suie 218
Fairfax, VA 22031-5207
Phone (703) 207-9077

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
0401007786VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210204800000",
    "number": "1346417474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8316 ARLINGTON BLVD",
            "address_2": "SUIE 218",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220315207",
            "telephone_number": "703-207-9077",
            "fax_number": "703-207-9079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8316 ARLINGTON BLVD",
            "address_2": "SUIE 218",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220315207",
            "telephone_number": "703-207-9077",
            "fax_number": "703-207-9079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOON",
        "first_name": "JAE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-08",
        "last_updated": "2008-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401007786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; 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.