Min Young Jo, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

100718 Issued in CA

Practice address

16475 Sierra Lakes Pkwy Ste 140
Fontana, CA 92336-1259

Phone

(909) 357-0869

NPI assigned

Aug 22, 2016

Last updated

Aug 22, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Jefferson and Chokka Dental Corporation

  dba Sierra Lakes Dental Group

  • General Practice Dentistry
  • Fontana, CA
  • NPI 1902003593
  NPD (past)

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471824000000",
    "number": "1447705397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4287 CLYDESDALE WAY",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917634179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16475 SIERRA LAKES PKWY STE 140",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361259",
            "telephone_number": "909-357-0869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JO",
        "first_name": "MIN",
        "middle_name": "YOUNG",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-22",
        "last_updated": "2016-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "100718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kalila Jimenez
• Kelly Ann Jimenez
• Laura Ysolina Jimenez, D.D.S
• Maribel M Jimenez
• Jo-Ann de Jesus Africa DDS Inc
• Jessica Pinpin Jocson, MD
• Joel Kim DMD Inc (Children Dental World)
• Heidi Gay Joffrion, PSY.D., M.F.T.
• Samir D. Johna, MD
• Flora H. Johnson, MD

• Dentist in Fontana, CA
• Providers in Fontana, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.