Active NPI
Jong Koo Byun, DDS
- General Practice Dentistry
- Yadkinville, NC
National Provider Identifier
1477539864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6961
- Practice address
- 114 W Main St
Yadkinville, NC 27055 - Phone
- (336) 679-2181
- Fax
- (336) 679-2753
- NPI assigned
- Dec 19, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6961 | NC | Primary |
Addresses
Primary practice location
114 W Main St
Yadkinville, NC 27055
Mailing address
PO Box 219
Yadkinville, NC 27055-0219
Phone (336) 679-2181
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160531001510 | NC | Order and Referring Only - Dentist | 5496045684 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6961 | NC | MD | General Practice Dentistry |
| 9691 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1477539864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 219",
"city": "YADKINVILLE",
"state": "NC",
"postal_code": "270550219",
"telephone_number": "336-679-2181",
"fax_number": "336-679-2753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 W MAIN ST",
"city": "YADKINVILLE",
"state": "NC",
"postal_code": "27055",
"telephone_number": "336-679-2181",
"fax_number": "336-679-2753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BYUN",
"first_name": "JONG",
"middle_name": "KOO",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-19",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "6961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yadkinville, NC
- Cynthia Brown Stiltner, NCC, LCAS-A, LCMHCA
- Hope Bryant
- Kayla Gentry Bullard, MSW, LCSWA
- Wanda J Burger, LPC
- Brooke Leigh Butler
- Cah Acquisition Company 10 LLC (Yadkin Valley Community Hospital)
- Cah Acquisition Company 10 LLC (Yadkin Valley Community Hosptial Professional Staff)
- Cah Acquisition Company 10 LLC (Yadkin Valley Community Physcians)
- Cah Acquisition Company 10 LLC (Yadkin Valley Community Hospital)
- Matthew A Cain, PTA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.