Jinwoo Jeong, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

106924 Issued in CA

Practice address

38056 Martha Ave
Fremont, CA 94536-3809

Phone

(510) 505-9409

NPI assigned

Sep 14, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1093485815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 CRESCENT VILLAGE CIR UNIT 1429",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951343525",
            "telephone_number": "847-715-8182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38056 MARTHA AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945363809",
            "telephone_number": "510-505-9409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEONG",
        "first_name": "JINWOO",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "106924",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connie Jenkins
• Jennifer Sun DDS Inc
• Joanna Elizabeth Gonzalez Jensen
• Meagan Jensen
• NA Eun Jeon, OTR/L
• Ryan W. Jergensen, DDS
• Jerry Yang DDS Inc.
• Diane Drumond Jesus
• Hee Kyung Jeung
• Jayanti Jha, MD

• General Practice Dentistry in Fremont, CA
• Providers in Fremont, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.