Active NPI
James J Jeong, DDS
- Dentist
- Fort Meade, MD
National Provider Identifier
1164949913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 16511
- Practice address
- 8476 Simmond St
Fort Meade, MD 20755-7083 - Phone
- (301) 677-6122
- NPI assigned
- Aug 23, 2017
- Last updated
- Aug 23, 2017
- Sex
- Male
- Sole proprietor
- No
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 | 16511 | MD | Primary |
Addresses
Primary practice location
8476 Simmond St
Fort Meade, MD 20755-7083
Mailing address
U.S. Army Dental Activity
8476 Simonds St
Fort Meade, MD 20755
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 |
|---|---|---|---|
| 16511 | MD | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503446400000",
"number": "1164949913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "U.S. ARMY DENTAL ACTIVITY",
"address_2": "8476 SIMONDS ST",
"city": "FORT MEADE",
"state": "MD",
"postal_code": "20755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8476 SIMMOND ST",
"city": "FORT MEADE",
"state": "MD",
"postal_code": "207557083",
"telephone_number": "301-677-6122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEONG",
"first_name": "JAMES",
"middle_name": "J",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-23",
"last_updated": "2017-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "16511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Meade, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.