NPIMap

Organization Active NPI

Jeon Prof. Dental Corporation

  • Dental Clinic/Center
  • La Habra, CA
National Provider Identifier
1265625099
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
46270 Issued in CA
Legal business name
JEON PROF. DENTAL CORPORATION
Practice address
116 W la Habra Blvd
La Habra, CA 90631-5402
Phone
(562) 697-7678
Fax
(562) 905-3272
NPI assigned
Aug 24, 2007
Last updated
Sep 4, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2007

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

Authorized official

Name
Yeong Rok JeonNPI 1831230994
Title
Ceo
Phone
(562) 697-7678

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 46270 CA Primary

Addresses

Primary practice location

116 W la Habra Blvd
La Habra, CA 90631-5402

Mailing address

116 W la Habra Blvd
La Habra, CA 90631-5402
Phone (562) 697-7678

National Provider Directory

National Provider Directory

Locations

116 W La Habra Blvd
La Habra, CA 90631
Phone (562) 697-7678

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188864000000",
    "number": "1265625099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 W LA HABRA BLVD",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906315402",
            "telephone_number": "562-697-7678",
            "fax_number": "562-905-3272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 W LA HABRA BLVD",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906315402",
            "telephone_number": "562-697-7678",
            "fax_number": "562-905-3272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEON PROF. DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-24",
        "last_updated": "2007-09-04",
        "status": "A",
        "authorized_official_last_name": "JEON",
        "authorized_official_first_name": "YEONG",
        "authorized_official_middle_name": "ROK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-697-7678"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "46270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Habra, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; 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.