Shieun Jang

Primary specialty

DentistTaxonomy code 122300000X

License

DE60603857 Issued in WA

Practice address

702 S Hill Park Dr Ste 201
Puyallup, WA 98373-1426

Phone

(855) 433-6825

NPI assigned

Oct 8, 2015

Last updated

Jan 29, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Willamette Dental Group, P.C.

  • Dentist
  • Puyallup, WA
  • NPI 1174448534
  NPD (past)

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1225409824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6950 NE CAMPUS WAY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245611",
            "telephone_number": "855-433-6825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 S HILL PARK DR STE 201",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983731426",
            "telephone_number": "855-433-6825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "509 Olive Way",
            "address_2": "Suite 1122",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981011720",
            "country_code": "US",
            "telephone_number": "206-432-4707",
            "fax_number": "206-467-1125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANG",
        "first_name": "SHIEUN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-08",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60603857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kameryn A Jadoo
• Matt Karl Jahns, LMP
• Melody Ann Jameson
• Janet P Neal (Neal Chiropractic Center)
• Kevin Wing Jang, RPH
• Montu Devendra Jani
• Peter Kelley Janicki, PT
• Nicole Lee Jaramillo, COTA/L.
• Jarascare LLC
• Mitali Jariwala

• Dentist in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.