Active NPI
Minjin Yoo, DMD
- Pediatric Dentistry
- Marlboro, NJ
National Provider Identifier
1417450073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 22DI02885100
- Practice address
- 7 S Main St Ste G
Marlboro, NJ 07746-1578 - Phone
- (202) 999-7886
- NPI assigned
- Mar 9, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 12219 | CT | |
| Pediatric Dentistry | 1223P0221X | 22DI02885100 | NJ | Primary |
Addresses
Primary practice location
7 S Main St Ste G
Marlboro, NJ 07746-1578
Mailing address
405 King George Rd Apt B-221
Basking Ridge, NJ 07920-2812
Phone (202) 999-7886
Other practice location 1
263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-2000
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02885100 | NJ | MD | Pediatric Dentist |
| 12219 | CT | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655251200000",
"number": "1417450073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 KING GEORGE RD APT B-221",
"city": "BASKING RIDGE",
"state": "NJ",
"postal_code": "079202812",
"telephone_number": "202-999-7886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 S MAIN ST STE G",
"city": "MARLBORO",
"state": "NJ",
"postal_code": "077461578",
"telephone_number": "202-999-7886"
}
],
"practiceLocations": [
{
"address_1": "263 Farmington Ave",
"address_purpose": "LOCATION",
"city": "Farmington",
"state": "CT",
"postal_code": "06030",
"country_code": "US",
"telephone_number": "860-679-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YOO",
"first_name": "MINJIN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-09",
"last_updated": "2022-06-15",
"certification_date": "2022-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CT",
"license": "12219",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NJ",
"license": "22DI02885100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marlboro, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.