Individual provider Active NPI

Min Yang

  • Dentist
  • Philadelphia, PA
National Provider Identifier
1457814949
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS042703 Issued in PA
Practice address
240 S 40TH St
Philadelphia, PA 19104-6030
Phone
(857) 277-8308
NPI assigned
Apr 11, 2019
Last updated
Jun 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X DS042703 PA Primary

Addresses

Primary practice location

240 S 40TH St
Philadelphia, PA 19104-6030

Mailing address

2101 Market St Unit 2303
Philadelphia, PA 19103-1363
Phone (857) 277-8308

Other practice location 1

9245 Rainier Ave S
Seattle, WA 98118-5569
Phone (206) 461-6981

Other practice location 2

9040 Rainier Ave S
Seattle, WA 98118-5000
Phone (206) 723-7221

Other practice location 3

9040 Rainier Ave S
Seattle, WA 98118-5000
Phone (206) 723-7221

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
DS042703PAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Rainier Beach Dental Dentist Past Accepting new patients
Park & Hong, PLLC Dentist Past 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": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1457814949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 MARKET ST UNIT 2303",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191031363",
            "telephone_number": "857-277-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 S 40TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191046030",
            "telephone_number": "857-277-8308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9245 Rainier Ave S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981185569",
            "country_code": "US",
            "telephone_number": "206-461-6981",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9040 Rainier Ave S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981185000",
            "country_code": "US",
            "telephone_number": "206-723-7221",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9040 Rainier Ave S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981185000",
            "country_code": "US",
            "telephone_number": "206-723-7221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANG",
        "first_name": "MIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-11",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS042703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.