Active NPI
Sooji Jeon
- Pharmacist
- Fairfax, VA
National Provider Identifier
1629932629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH200005121
- Practice address
- 3905 Fair Ridge Dr
Fairfax, VA 22033-2906 - Phone
- (703) 717-8094
- NPI assigned
- Dec 13, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH200005121 | DC | Primary |
Addresses
Primary practice location
3905 Fair Ridge Dr
Fairfax, VA 22033-2906
Mailing address
4046 Timber Oak TRL
Fairfax, VA 22033-6223
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH200005121 | DC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1765584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765584000000",
"number": "1629932629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4046 TIMBER OAK TRL",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220336223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3905 FAIR RIDGE DR",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220332906",
"telephone_number": "703-717-8094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEON",
"first_name": "SOOJI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-12-13",
"last_updated": "2025-12-13",
"certification_date": "2025-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "DC",
"license": "PH200005121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.