NPIMap

Organization Active NPI

Charles Jeong DDS

  • Oral and Maxillofacial Surgery Clinic/Center
  • Flushing, NY
National Provider Identifier
1194385609
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
Legal business name
CHARLES JEONG DDS
Practice address
16410 Northern Blvd Ste 102
Flushing, NY 11358-2668
Phone
(718) 762-1700
NPI assigned
Jun 17, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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

Authorized official

Name
Charles Jeong, DDSNPI 1669671970
Title
Owner
Phone
(718) 762-1700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X Primary

Addresses

Primary practice location

16410 Northern Blvd Ste 102
Flushing, NY 11358-2668

Mailing address

16410 Northern Blvd Ste 102
Flushing, NY 11358-2668

National Provider Directory

National Provider Directory

Locations

16410 Northern Blvd
Ste 102
Flushing, NY 11358
Phone (718) 762-1700

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560729600000",
    "number": "1194385609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16410 NORTHERN BLVD STE 102",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113582668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16410 NORTHERN BLVD STE 102",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113582668",
            "telephone_number": "718-762-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES JEONG DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-17",
        "last_updated": "2019-06-17",
        "status": "A",
        "authorized_official_last_name": "JEONG",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-762-1700",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; 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.