Active NPI
Jae S Yoon, DDS
- Dentist
- Fairfax, VA
National Provider Identifier
1346417474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401007786
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 0401007786 | VA | MD | Dentist |
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.