Active NPI
Yeon Jin Jung, DMD
- Dentist
- Richland, WA
National Provider Identifier
1770142705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE61291968
- Practice address
- 2469 Queensgate Dr
Richland, WA 99352-9120 - Phone
- (509) 628-1144
- NPI assigned
- Jun 12, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D11631 | OR | |
| General Practice Dentistry | 1223G0001X | D11631 | OR | |
| Dentist | 122300000X | DE61291968 | WA | Primary |
Addresses
Primary practice location
2469 Queensgate Dr
Richland, WA 99352-9120
Mailing address
2469 Queensgate Dr
Richland, WA 99352-9120
Phone (509) 628-1144
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 |
|---|---|---|---|
| DE61291968 | WA | MD | Dentist |
| D11631 | OR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jeffrey T. Meister, DDS, LLC | General Practice | Past | Accepting new patients |
| Lifetime Dental Care | General Practice | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Practice Dentistry
- Richland, WA
- NPI 1578812137
-
- General Practice Dentistry
- Munster, IN
- NPI 1821207853
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724198400000",
"number": "1770142705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2469 QUEENSGATE DR",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993529120",
"telephone_number": "509-628-1144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2469 QUEENSGATE DR",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993529120",
"telephone_number": "509-628-1144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUNG",
"first_name": "YEON JIN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-12",
"last_updated": "2024-08-21",
"certification_date": "2024-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D11631",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "D11631",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE61291968",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.