Individual provider Active NPI

Anthony Yun Jong, D.D.S.

  • General Practice Dentistry
  • Torrance, CA
National Provider Identifier
1114058955
Registry record updated Jun 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
B39018 Issued in CA
Practice address
23000 Crenshaw Blvd Ste 207
Torrance, CA 90505-3052
Phone
(310) 325-5100
Fax
(310) 325-5458
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X B39018 CA Primary

Addresses

Primary practice location

23000 Crenshaw Blvd Ste 207
Torrance, CA 90505-3052

Mailing address

23701 Arlington Ave
Torrance, CA 90501-6145
Phone (310) 325-5100

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
B39018CAMDGeneral Practice Dentistry
39018CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466726400000",
    "number": "1114058955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23701 ARLINGTON AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905016145",
            "telephone_number": "310-325-5100",
            "fax_number": "310-325-5458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23000 CRENSHAW BLVD STE 207",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905053052",
            "telephone_number": "310-325-5100",
            "fax_number": "310-325-5458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONG",
        "first_name": "ANTHONY",
        "middle_name": "YUN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2016-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "B39018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2016; 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.