Individual provider Active NPI

Alexis Bunhong Youn, DDS

  • Dentist
  • Chicago, IL
National Provider Identifier
1447551155
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019028790 Issued in IL
Practice address
1844 W Chicago Ave
Chicago, IL 60622
Phone
(312) 322-6882
Fax
(312) 322-6881
NPI assigned
Nov 11, 2010
Last updated
Oct 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019028790 IL Primary
General Practice Dentistry 1223G0001X 2901020268 MI

Addresses

Primary practice location

1844 W Chicago Ave
Chicago, IL 60622

Mailing address

2 E Erie St
Apt 3901
Chicago, IL 60611-2724
Phone (734) 604-1271

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
019028790ILMDDentist
2901020268MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Alexis B Youn Dental LTD General Practice Past Accepting new patients

Organizations & group practices 1

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": "1289433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1447551155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 E ERIE ST",
            "address_2": "APT 3901",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112724",
            "telephone_number": "734-604-1271",
            "fax_number": "312-322-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1844 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60622",
            "telephone_number": "312-322-6882",
            "fax_number": "312-322-6881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUN",
        "first_name": "ALEXIS",
        "middle_name": "BUNHONG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-11",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019028790",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020268",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; 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.