Provider Demographics
NPI:1245528868
Name:YOON, JENNI YEOJIN (MD)
Entity type:Individual
Prefix:
First Name:JENNI
Middle Name:YEOJIN
Last Name:YOON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10301 GEORGIA AVE STE 306
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-5020
Mailing Address - Country:US
Mailing Address - Phone:301-681-6055
Mailing Address - Fax:301-681-9670
Practice Address - Street 1:10301 GEORGIA AVE STE 306
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5020
Practice Address - Country:US
Practice Address - Phone:301-681-6055
Practice Address - Fax:301-681-9670
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-17
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD80546207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program