Individual provider Active NPI

Julia Hye Eun Son

  • Dentist
  • Lubbock, TX
National Provider Identifier
1619607934
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
38470 Issued in TX
Practice address
5255 79TH St
Lubbock, TX 79424-2852
Phone
(806) 794-7171
NPI assigned
Jun 10, 2022
Last updated
Jun 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 38470 TX Primary

Addresses

Primary practice location

5255 79TH St
Lubbock, TX 79424-2852

Mailing address

5308 Lehigh St
Lubbock, TX 79416-2348

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220719003963 TX Order and Referring Only - DentistPractitioner - Dentist 9032590245

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38470TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lena Shoukfeh Kharrat DDS PA Dentist CurrentSince Mar 11, 2025 Accepting new patients
Abbeville Family Dentistry CurrentSince Jun 12, 2022 Accepting new patients

Locations

5255 79th St
Lubbock, TX 79424
Phone (806) 438-5745

Organizations & group practices 2

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": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1619607934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5308 LEHIGH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794162348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 79TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794242852",
            "telephone_number": "806-794-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SON",
        "first_name": "JULIA",
        "middle_name": "HYE EUN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "38470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.