Min Jung Jin, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D012272 Issued in AZ

Practice address

11259 S Frontage Rd Ste 103
Yuma, AZ 85367-7883

Phone

(928) 770-1042

NPI assigned

Jun 29, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1447937610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5336 E 34TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853659548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11259 S FRONTAGE RD STE 103",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853677883",
            "telephone_number": "928-770-1042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7949 E 24th St",
            "address_purpose": "LOCATION",
            "city": "Yuma",
            "state": "AZ",
            "postal_code": "853658602",
            "country_code": "US",
            "telephone_number": "928-249-3673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIN",
        "first_name": "MIN JUNG",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-29",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108885",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D012272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candice Michelle Jensen, M.D., PLLC
• Lea S Jerpseth, NP-C
• Peggy Ann Jessen, BSN RN
• Jessica Duggan DPM PC
• Cristina Jimenez Ponce, LPC
• Johanna M Richey, DPM, PC
• John G. Ridgway, D.O. P. C.
• John Michael Lewis, MD PC
• Robert Johns, M. D.
• Aaliyah K Johnson, RBT

• General Practice Dentistry in Yuma, AZ
• Providers in Yuma, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.