Bom Jeon Dental Corp

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BOM JEON DENTAL CORP

Practice address

1401 S Brookhurst Rd Ste 104
Fullerton, CA 92833-4492

Phone

(714) 879-2828

NPI assigned

Apr 29, 2021

Organization subpart

No

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

Authorized official

Name

Bom Jeon, DDS

Title

President

Phone

(714) 485-9999

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1013590025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S BROOKHURST RD STE 104",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928334492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S BROOKHURST RD STE 104",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928334492",
            "telephone_number": "714-879-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOM JEON DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "JEON",
        "authorized_official_first_name": "BOM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-485-9999",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Boghossian, DC
• Shawna Bohannon Browne, LCSW
• Lidia Inel Bojorquez
• Lisa Ann Bojorquez
• Richard Charles Bollin Jr., MD
• Bom Seok Jeon, DDS, Inc
• Bom Vichae Home Health Agency LLC
• Bom Vichae Physical Therapy Professional Corporation
• Frank Anthony Bonavita, MD
• David Michael Boner

• Dental Clinic/Center in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.