Healthcare Provider Details

I. General information

NPI: 1245528868
Provider Name (Legal Business Name): JENNI YEOJIN YOON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2011
Last Update Date: 08/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10301 GEORGIA AVE STE 306
SILVER SPRING MD
20902-5020
US

IV. Provider business mailing address

10301 GEORGIA AVE STE 306
SILVER SPRING MD
20902-5020
US

V. Phone/Fax

Practice location:
  • Phone: 301-681-6055
  • Fax: 301-681-9670
Mailing address:
  • Phone: 301-681-6055
  • Fax: 301-681-9670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberD80546
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: