SE-Young Jeon, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401416390 Issued in VA

Practice address

5130 Duke St Ste 4
Alexandria, VA 22304-2955

Phone

(703) 370-6500

NPI assigned

Jul 12, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• SJ Dentistry LLC

  • General Practice Dentistry
  • Fairfax, VA
  • NPI 1386519049
  NPD Authorized official
• Landmark Dental, P.C.

  • General Practice Dentistry
  • Alexandria, VA
  • NPI 1922865781
  NPD
• J Kim DDS and R Kim DDS PC

  • General Practice Dentistry
  • Fairfax, VA
  • NPI 1578721601
  NPD (past)

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1982126884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 CALAIS POINT CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220336200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 DUKE ST STE 4",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223042955",
            "telephone_number": "703-370-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8622 Lee Hwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220312148",
            "country_code": "US",
            "telephone_number": "703-876-4600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEON",
        "first_name": "SE-YOUNG",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401416390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delonte Tavon Jennings
• Stefanie Jennings, FNP-C
• Jenny Yung, MD PLLC
• Jennifer Lynn Jensen, PA-C
• Natalie Jensen
• Jerald J. Littlefield, MD, PC
• Leslie Clare Jerkins, MSW
• Jerrold H Epstein Dos PC
• Donna Jessen, LICSW
• Jessica K Mann LLC

• General Practice Dentistry in Alexandria, VA
• Providers in Alexandria, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.