Individual provider Active NPI

Sooyeon Kelly Youn

  • Endodontics
  • Silver Spring, MD
National Provider Identifier
1699036277
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
14860 Issued in MD
Practice address
13975 Connecticut Ave Ste 208
Silver Spring, MD 20906-2921
Phone
(301) 598-3951
NPI assigned
May 31, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401413482 VA
Dentist 122300000X 14860 MD
Dentist 122300000X DEN1001399 DC
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 14860 MD Primary

Addresses

Primary practice location

13975 Connecticut Ave Ste 208
Silver Spring, MD 20906-2921

Mailing address

13975 Connecticut Ave Ste 208
Silver Spring, MD 20906-2921
Phone (301) 598-3951

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
I20260624000997 TX Order and Referring Only - DentistPractitioner - Dentist 4385117126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN1001399DCMDDentist
0401413482VAMDDentist
14860MDMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Dental Specialty Group Dentist PastSince Jul 13, 2025 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.

NPI Registry JSON

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1699036277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13975 CONNECTICUT AVE STE 208",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209062921",
            "telephone_number": "301-598-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13975 CONNECTICUT AVE STE 208",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209062921",
            "telephone_number": "301-598-3951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUN",
        "first_name": "SOOYEON",
        "middle_name": "KELLY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-31",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413482",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "14860",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "DEN1001399",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "MD",
            "license": "14860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.