Individual provider Active NPI

Stephanie Hue Yee Jue

  • Endodontics
  • Chula Vista, CA
National Provider Identifier
1477174779
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
110120 Issued in CA
Practice address
878 Eastlake Pkwy Ste 1511
Chula Vista, CA 91914-4550
Phone
(619) 739-4936
NPI assigned
Apr 28, 2020
Last updated
Jun 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NC
Endodontics 1223E0200X 110120 CA Primary
Dentist 122300000X DN1858893 MA

Addresses

Primary practice location

878 Eastlake Pkwy Ste 1511
Chula Vista, CA 91914-4550

Mailing address

9822 Camelot St
Pickerington, OH 43147-8571
Phone (770) 722-7921

Other practice location 1

101 Manning Dr
Chapel Hill, NC 27514-4220
Phone (919) 537-3719

Other practice location 2

188 Longwood Ave
Boston, MA 02115-5819
Phone (617) 432-1434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20200701003671 NC Order and Referring Only - DentistPractitioner - Dentist 4082037411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110120CAMDClinical Social Worker
DN1858893MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Rygg and Singh Dental Corporation PastSince Jun 30, 2024 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": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1477174779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9822 CAMELOT ST",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431478571",
            "telephone_number": "770-722-7921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "878 EASTLAKE PKWY STE 1511",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919144550",
            "telephone_number": "619-739-4936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Manning Dr",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275144220",
            "country_code": "US",
            "telephone_number": "919-537-3719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "188 Longwood Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155819",
            "country_code": "US",
            "telephone_number": "617-432-1434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUE",
        "first_name": "STEPHANIE",
        "middle_name": "HUE YEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-28",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "110120",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1858893",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.