Active NPI
Woo Seok Jang, D.D.S.
- Dentist
- Plano, TX
National Provider Identifier
1194030361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 25868
- Practice address
- 6313 Preston Rd Ste 100
Plano, TX 75024-2679 - Phone
- (962) 801-2788
- NPI assigned
- Aug 12, 2010
- 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 | 25868 | TX | Primary |
Addresses
Primary practice location
6313 Preston Rd Ste 100
Plano, TX 75024-2679
Mailing address
6313 Preston Rd Suite 100
Plano, TX 75024
Phone (972) 801-2788
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 16, 2017 through Mar 16, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25868 | TX | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pinnacle Dental | 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.
-
- General Practice Dentistry
- Plano, TX
- NPI 1104918283
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498521600000",
"number": "1194030361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6313 PRESTON RD SUITE 100",
"city": "PLANO",
"state": "TX",
"postal_code": "75024",
"telephone_number": "972-801-2788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6313 PRESTON RD STE 100",
"city": "PLANO",
"state": "TX",
"postal_code": "750242679",
"telephone_number": "962-801-2788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANG",
"first_name": "WOO",
"middle_name": "SEOK",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-12",
"last_updated": "2017-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "25868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.