Individual provider Active NPI

John C Yi, DDS

  • General Practice Dentistry
  • Alexandria, VA
National Provider Identifier
1861652695
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401410295 Issued in VA
Practice address
4660 Kenmore Ave
Suite 318
Alexandria, VA 22304-1313
Phone
(703) 751-7300
Fax
(703) 751-4017
NPI assigned
Jun 16, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401410295 VA Primary

Addresses

Primary practice location

4660 Kenmore Ave
Suite 318
Alexandria, VA 22304-1313

Mailing address

4660 Kenmore Ave
Suite 318
Alexandria, VA 22304-1313
Phone (703) 751-7300

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

LicenseStateTypeSpecialty
0401410295VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1861652695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE",
            "address_2": "SUITE 318",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041313",
            "telephone_number": "703-751-7300",
            "fax_number": "703-751-4017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE",
            "address_2": "SUITE 318",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041313",
            "telephone_number": "703-751-7300",
            "fax_number": "703-751-4017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YI",
        "first_name": "JOHN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.