Individual
JAEWON YOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
14631 LEE HWY STE 116, CENTREVILLE, VA 20121-5825
(703) 447-5204
Mailing address
14631 LEE HWY STE 116, CENTREVILLE, VA 20121-5825
(703) 447-5204
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DS038113
PA
1223G0001X
General Practice Dentistry
Primary
0401412648
VA
1223G0001X
General Practice Dentistry
14679
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026866600
—
MD
Enumeration date
09/28/2009
Last updated
08/29/2013
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