Tae Youn DDS MD PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

TAE YOUN DDS MD PLLC

Doing business as

Everett Oral and Implant Surgery
Mill Creek Oral and Implant Surgery

Practice address

1429 Broadway
Everett, WA 98201-1719

Phone

(425) 318-4789

NPI assigned

Jun 2, 2020

Organization subpart

No

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

Authorized official

Name

Tae Lim Youn, DDS, MDNPI 1275858169

Title

Oral Surgeon

Phone

(425) 318-4789

Specialties & licenses 1

Addresses

Other names 2

• Everett Oral and Implant Surgery Doing business as
• Mill Creek Oral and Implant Surgery Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tae Lim Youn, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Everett, WA
  • NPI 1275858169
  NPD Authorized official

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1679197016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1429 BROADWAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011719",
            "telephone_number": "425-318-4789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1429 BROADWAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011719",
            "telephone_number": "425-318-4789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15808 Mill Creek Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Mill Creek",
            "state": "WA",
            "postal_code": "980121500",
            "country_code": "US",
            "telephone_number": "425-318-4789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TAE YOUN DDS MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-02",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "YOUN",
        "authorized_official_first_name": "TAE LIM",
        "authorized_official_title_or_position": "ORAL SURGEON",
        "authorized_official_telephone_number": "425-318-4789",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Everett Oral and Implant Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mill Creek Oral and Implant Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melanie Szyperski
• Hosna Sadat Tabatabaifar, PHARMD
• Roger Taber, MD
• Lacey Jade Tachiquin
• Sosina Tadesse
• Misrak Tafese, MA60133679
• Mariko Watts Taggart
• Oliver Shu-on Tai, MD
• Rebecca Taicz, PHARMD
• Daniele Taitague

• Oral and Maxillofacial Surgery (Dentist) in Everett, WA
• Providers in Everett, WA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.