Individual provider Active NPI

Jingzheng Yi, DDS

  • Dentist
  • Fresno, CA
National Provider Identifier
1417684598
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
108734 Issued in CA
Practice address
3920 N Cedar Ave
Fresno, CA 93726-5270
Phone
(559) 412-5515
NPI assigned
Aug 8, 2022
Last updated
May 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D14793 MN
Dentist 122300000X 108734 CA Primary

Addresses

Primary practice location

3920 N Cedar Ave
Fresno, CA 93726-5270

Mailing address

2350 E Alluvial Ave Apt 108
Fresno, CA 93720-0479
Phone (858) 888-6340

Other practice location 1

2120 US-14 East
rochester, MN 55904
Phone (507) 258-7934

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
108734CAMDDentist
D14793MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Dental Services, Inc. Dentist PastSince May 14, 2023 Accepting new patients
Community Dental Care PastSince Aug 1, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1417684598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 E ALLUVIAL AVE APT 108",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937200479",
            "telephone_number": "858-888-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 N CEDAR AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937265270",
            "telephone_number": "559-412-5515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2120 US-14 East",
            "address_purpose": "LOCATION",
            "city": "rochester",
            "state": "MN",
            "postal_code": "55904",
            "country_code": "US",
            "telephone_number": "507-258-7934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YI",
        "first_name": "JINGZHENG",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14793",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.

Verify at the official NPI Registry.