Active NPI
Grace Seung-Ah Jung, D.D.S.
- Pediatric Dentistry
- Lancaster, CA
National Provider Identifier
1194981837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 56747
- Practice address
- 44244 Division St
Lancaster, CA 93535-3525 - Phone
- (661) 942-6200
- NPI assigned
- Aug 1, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 56747 | CA | Primary |
Addresses
Primary practice location
44244 Division St
Lancaster, CA 93535-3525
Mailing address
15130 Dickens St
#208
Sherman Oaks, CA 91403-5328
Phone (310) 892-5543
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 |
|---|---|---|---|
| 56747 | CA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Miles Madison, a Professional Dental Corporation | 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.
-
dba Dental Specialty Care of Lancaster
- Dentist
- Lancaster, CA
- NPI 1386815058
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218758400000",
"number": "1194981837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15130 DICKENS ST",
"address_2": "#208",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914035328",
"telephone_number": "310-892-5543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44244 DIVISION ST",
"city": "LANCASTER",
"state": "CA",
"postal_code": "935353525",
"telephone_number": "661-942-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUNG",
"first_name": "GRACE",
"middle_name": "SEUNG-AH",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-01",
"last_updated": "2008-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "56747",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lancaster, CA
- Paul Rudy Juarez
- Stacey Juarez
- Yuliana Juarez
- Tammy Julian
- Heesu Jun, PHARMD
- Claire Ovidia Justice, PHN
- Mae Judith-Marie Justus, B.S
- JWCH Institute Inc (Wesley Health Centers - Health and Wellness Center 2)
- JWCH Institute, Inc. (Wesley Health Centers - Mobile Health Clinic I)
- JWCH Institute, Inc. (Wesley Health Centers- Health and Wellness Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.