Sophie Ju Hyung Moon

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.032544 Issued in IL

Practice address

801 S Paulina St RM 131
Chicago, IL 60612-7210

Phone

(312) 996-7138

NPI assigned

Apr 13, 2020

Sex

Female

Sole proprietor

Yes

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": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1457970147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4529 GILBERTSON RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220323615",
            "telephone_number": "202-480-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S PAULINA ST RM 131",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127210",
            "telephone_number": "312-996-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "SOPHIE",
        "middle_name": "JU HYUNG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.032544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moon Rabbit Acupuncture & Eastern Medicine LLC
• Cynthia H Moon, M.D.
• Ellen Moon, NP
• Kathryn A Moon, M.A., L.C.P.C.
• Kennon Whiting Moon
• Steve Sukho Moon
• Grace Mooney-Melvin, LCSW
• Angela C Mooney, MS, CCC-SLP
• Jessica Mooney, CCC-SLP
• Melissa Mooney, LPC

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.