John Jip Yoon, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2019038729 Issued in MO

Practice address

725 W Mount Vernon St
Nixa, MO 65714-9663

Phone

(417) 708-9098

NPI assigned

Jun 20, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1417152158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 E ELEVEN POINT LN",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657147931",
            "telephone_number": "317-413-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 W MOUNT VERNON ST",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657149663",
            "telephone_number": "417-708-9098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3837 N High School Rd",
            "address_2": "ste 12",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462542742",
            "country_code": "US",
            "telephone_number": "317-522-0908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOON",
        "first_name": "JOHN",
        "middle_name": "JIP",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-20",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2019038729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Nixa, MO
• Providers in Nixa, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.