Active NPI
Youngjae Sung, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Chicago, IL
National Provider Identifier
1033845524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 063098
- Practice address
- 801 S Paulina St RM 131
Chicago, IL 60612-7210 - Phone
- (312) 996-7555
- NPI assigned
- Jul 27, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 063098 | NY | Primary |
| Dentist | 122300000X | 019.032881 | IL |
Addresses
Primary practice location
801 S Paulina St RM 131
Chicago, IL 60612-7210
Mailing address
63 Wall Street 2106
New York, NY 10005
Phone (781) 315-3394
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.032881 | IL | MD | Dentist |
| 063098 | NY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1033845524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "63 WALL STREET 2106",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10005",
"telephone_number": "781-315-3394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 S PAULINA ST RM 131",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606127210",
"telephone_number": "312-996-7555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUNG",
"first_name": "YOUNGJAE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-27",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NY",
"license": "063098",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist",
"state": "IL",
"license": "019.032881",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.