Sung Yeon Ji, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D10100 Issued in OR

Practice address

927 Country Club Rd Ste 100
Eugene, OR 97401-6018

Phone

(458) 201-8471

NPI assigned

Aug 8, 2013

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

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ji Family Dental LLC

  • Dental Clinic/Center
  • Oregon City, OR
  • NPI 1124521166
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442880000000",
    "number": "1609208040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13190 SE 162ND AVE APT 219",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970153780",
            "telephone_number": "971-266-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 COUNTRY CLUB RD STE 100",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016018",
            "telephone_number": "458-201-8471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JI",
        "first_name": "SUNG YEON",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-08",
        "last_updated": "2015-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029604",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hillary Lind Jewell
• Mark L Jewell, M.D.
• Aidan Jewett
• Andrea Lynn Jewett, APRN-NP
• Brian Jewett, MD
• Amada L Jimenez, PSYD
• Rosamabelle B Jimenez, LMT
• Ting Jing
• Shehzad Jinnah, MD
• JLC Counseling LMFT LLC

• Dentist in Eugene, OR
• Providers in Eugene, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; 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.

Verify at the official NPI Registry.