Active NPI
Sunjae Jung
- Dentist
- Richmond, CA
National Provider Identifier
1063909414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 102275
- Practice address
- 265 16TH St, Richmond
Richmond, CA 94801 - Phone
- (510) 233-6515
- NPI assigned
- Apr 20, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 102275 | CA | Primary |
Addresses
Primary practice location
265 16TH St, Richmond
Richmond, CA 94801
Mailing address
311 Tideway Dr Apt 215
Alameda, CA 94501-3537
Phone (805) 835-5136
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 |
|---|---|---|---|
| 102275 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chester T. Low, DDS, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dental Clinic/Center
- Richmond, CA
- NPI 1730257098
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524182400000",
"number": "1063909414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 TIDEWAY DR APT 215",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945013537",
"telephone_number": "805-835-5136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "265 16TH ST, RICHMOND",
"city": "RICHMOND",
"state": "CA",
"postal_code": "94801",
"telephone_number": "510-233-6515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUNG",
"first_name": "SUNJAE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-04-20",
"last_updated": "2018-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "102275",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.