Active NPI
Jina Youn
- Dentist
- Ontario, CA
National Provider Identifier
1528844123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 109312
- Practice address
- 4190 E 4TH St Ste C
Ontario, CA 91764-5263 - Phone
- (909) 532-8518
- NPI assigned
- Sep 7, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 109312 | CA | Primary |
Addresses
Primary practice location
4190 E 4TH St Ste C
Ontario, CA 91764-5263
Mailing address
24898 Sanitarium Drive Lindsay Hall #222
Loma Linda, CA 92350-1717
Phone (805) 717-5772
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- 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 |
|---|---|---|---|---|
| I20240130003408 | CA | Order and Referring Only - Dentist | 8123471786 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gill Dental Corporation | Past | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Ontario, CA
- NPI 1720251150
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694044800000",
"number": "1528844123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24898 SANITARIUM DRIVE LINDSAY HALL #222",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923501717",
"telephone_number": "805-717-5772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4190 E 4TH ST STE C",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917645263",
"telephone_number": "909-532-8518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUN",
"first_name": "JINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-07",
"last_updated": "2023-09-07",
"certification_date": "2023-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "109312",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.