NPI Code Detail JSON Logo

1538417795 NPI number — JEE HYUN LYU DDS

NPI Number: 1538417795
Health Care Provider/Practitioner: JEE HYUN LYU DDS

Information about “1538417795” NPI (JEE HYUN LYU DDS) exists in 1538417795 in HTML format HTML  |  1538417795 in plain Text format TXT  |  1538417795 in PDF (Portable Document Format) PDF  |  1538417795 in an XML format XML  formats.

NPI Number : 1538417795 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1538417795",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LYU",
    "FirstName": "JEE HYUN",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "DDS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "LYU",
    "OtherFirstName": "DIANA",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "13875 HWY 13, FRONTAGE RD",
    "SecondLineMailingAddress": "SUITE 50",
    "MailingAddressCityName": "SAVAGE",
    "MailingAddressStateName": "MN",
    "MailingAddressPostalCode": "55378",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "952-226-7940",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "13875 HWY 13, FRONTAGE RD",
    "SecondLinePracticeLocationAddress": "SUITE 50",
    "PracticeLocationAddressCityName": "SAVAGE",
    "PracticeLocationAddressStateName": "MN",
    "PracticeLocationAddressPostalCode": "55378",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "952-226-7940",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/20/2012",
    "LastUpdateDate": "11/07/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "122300000X",
          "TaxonomyName": "Dentist",
          "LicenseNumber": "RES.3257",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1223S0112X",
          "TaxonomyName": "Oral and Maxillofacial Surgery (Dentist)",
          "LicenseNumber": "R570",
          "LicenseNumberStateCode": "MN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1223S0112X",
          "TaxonomyName": "Oral and Maxillofacial Surgery (Dentist)",
          "LicenseNumber": "D13892",
          "LicenseNumberStateCode": "MN",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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