Provider Demographics
NPI:1356675581
Name:YOON, HEATHER HYEONMI (DDS)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:HYEONMI
Last Name:YOON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15054 STILLFIELD PL
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-1100
Mailing Address - Country:US
Mailing Address - Phone:703-988-0071
Mailing Address - Fax:
Practice Address - Street 1:15054 STILLFIELD PL
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120-1100
Practice Address - Country:US
Practice Address - Phone:703-988-0071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-21
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010079211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice