NPIMap

Organization Active NPI

JNL Dental Two

Doing business as Affordable Dental Center

  • General Practice Dentistry
  • Dracut, MA
National Provider Identifier
1013443761
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN1857532 Issued in MA
Legal business name
JNL DENTAL TWO
Doing business as
Affordable Dental Center
Practice address
1168 Lakeview Ave Ste 3
Dracut, MA 01826-4763
Phone
(978) 957-7009
NPI assigned
May 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jae Yong Jung
Title
Co-Owner
Phone
(347) 558-2076

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN1857532 MA Primary

Addresses

Primary practice location

1168 Lakeview Ave Ste 3
Dracut, MA 01826-4763

Mailing address

1168 Lakeview Ave Ste 3
Dracut, MA 01826-4763
Phone (978) 957-7009

Other names 1

  • Affordable Dental Center Doing business as

National Provider Directory

National Provider Directory

Locations

1168 Lakeview Ave
Ste 3
Dracut, MA 01826
Phone (978) 957-7009

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1013443761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1168 LAKEVIEW AVE STE 3",
            "city": "DRACUT",
            "state": "MA",
            "postal_code": "018264763",
            "telephone_number": "978-957-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1168 LAKEVIEW AVE STE 3",
            "city": "DRACUT",
            "state": "MA",
            "postal_code": "018264763",
            "telephone_number": "978-957-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JNL DENTAL TWO",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-01",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "JUNG",
        "authorized_official_first_name": "JAE YONG",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "347-558-2076",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1857532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affordable Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dracut, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.