Jiho Yang, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019.031555 Issued in IL

Practice address

843 W Broadway Ave
Medford, WI 54451-1307

Phone

(715) 785-8100

NPI assigned

Oct 20, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ji Ho Yang Other name

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Henderson County Rural Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Monmouth, IL
  • NPI 1144987975
  NPD (past)

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

{
    "created_epoch": "1508457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1952812612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 N SAINT JOSEPH AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544491340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "843 W BROADWAY AVE",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511307",
            "telephone_number": "715-785-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "JIHO",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-20",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6001884-15",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.031555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JI HO",
            "last_name": "YANG",
            "credential": "DMD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shannon Wiegel, BSN RN
• Wildberg Chiropractic Office SC
• Bradley Dale Wildberg, DC
• Korby J Wipf, MA CCC-SLP
• Anne Marie Wolf, PTA
• Kevin Kongmeng Yang
• Margaret Susan Young, MD
• Craig Zalizniak, DC
• Debra Jeanne Zenner, N.P.
• Shane Arthur Zertler

• Dentist in Medford, WI
• Providers in Medford, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.