Provider Demographics
NPI:1184784274
Name:COE, YONG JOON (DDS,MSD,MS)
Entity type:Individual
Prefix:DR
First Name:YONG
Middle Name:JOON
Last Name:COE
Suffix:
Gender:M
Credentials:DDS,MSD,MS
Other - Prefix:DR
Other - First Name:YONG JOON
Other - Middle Name:
Other - Last Name:KO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS,MSD,MS
Mailing Address - Street 1:19490 SANDRIDGE WAY STE 160
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-3469
Mailing Address - Country:US
Mailing Address - Phone:703-454-5656
Mailing Address - Fax:703-454-5056
Practice Address - Street 1:19490 SANDRIDGE WAY STE 160
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-3469
Practice Address - Country:US
Practice Address - Phone:703-454-5656
Practice Address - Fax:703-454-5056
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401412988122300000X, 1223P0700X
IA40091122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist