Yoon Dermatology LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

YOON DERMATOLOGY LLC

Practice address

1060 Meyer Rd
Wentzville, MO 63385-3800

Phone

(636) 466-1636

Fax

(314) 645-0446

NPI assigned

May 25, 2020

Last updated

Aug 6, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jaeyoung Yoon, MDNPI 1205885563

Title

Owner

Phone

(314) 230-1500

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jaeyoung Yoon, MD

  • Dermatology Physician
  • Wentzville, MO
  • NPI 1205885563
  Medicare reassignment Care Compare group NPD Authorized official
• Lindsey Graviett, M.D.

  • Dermatology Physician
  • Wentzville, MO
  • NPI 1235584822
  Medicare reassignment Care Compare group NPD
• Omar W Jassim, MD, PHD

  • Dermatology Physician
  • Wentzville, MO
  • NPI 1649397415
  Medicare reassignment Care Compare group NPD
• Madalyn Margaret Roller

  • Physician Assistant
  • Columbia, MO
  • NPI 1023839735
  Medicare reassignment Care Compare group NPD
• Laura J Sills, RN, MSN, ANP-BC

  • Nurse Practitioner
  • Wentzville, MO
  • NPI 1699804104
  Medicare reassignment Care Compare group NPD
• Stacy Gittel Blum, D.O.

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1952757007

  MO, Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Jacqueline Sova Castagno, PA-C

  • Physician Assistant
  • Wentzville, MO
  • NPI 1073852885
  Medicare reassignment Care Compare group
• Brenley Deters, PA-C

  • Physician Assistant
  • Wentzville, MO
  • NPI 1184323586
  Medicare reassignment Care Compare group
• Tara Ramachandra, MD

  • Facial Plastic Surgery Physician
  • Creve Coeur, MO
  • NPI 1801039516
  Medicare reassignment
• Tessa Marie Kreikemeier

  • Physician Assistant
  • Wentzville, MO
  • NPI 1932997145
  NPD

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

{
    "created_epoch": "1590364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785974400000",
    "number": "1811510886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 MEYER RD",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853800",
            "telephone_number": "314-230-1500",
            "fax_number": "314-230-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 MEYER RD",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853800",
            "telephone_number": "636-466-1636",
            "fax_number": "314-645-0446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2105 W Pearce Blvd",
            "address_purpose": "LOCATION",
            "city": "Wentzville",
            "state": "MO",
            "postal_code": "633853330",
            "country_code": "US",
            "telephone_number": "314-230-1500",
            "fax_number": "314-230-1122",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1015 Washington Sq Ste E",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "MO",
            "postal_code": "630905307",
            "country_code": "US",
            "telephone_number": "314-230-1500",
            "fax_number": "314-230-1122",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2325 Dougherty Ferry Rd Ste 207",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631223356",
            "country_code": "US",
            "telephone_number": "314-230-1500",
            "fax_number": "314-230-1122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "YOON DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-25",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A",
        "authorized_official_last_name": "YOON",
        "authorized_official_first_name": "JAEYOUNG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-230-1500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara L. Woodyard, LPC
• Zachary Wright, PHARMD
• Kristen Leigh Wurth, LPC
• X Chiropractic & Acupuncture LLC
• Xephyr M Day DC LLC
• Jaeyoung Yoon, MD
• Tiffany Young
• Samantha Marie Youngblood, DDS
• Brian Zellers, PHARMD
• Bernice Ziganto

• Dermatology Physician in Wentzville, MO
• Providers in Wentzville, MO by specialty
• Dermatology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.