Individual provider Active NPI

Yuseok Jung, DMD

  • Dentist
  • Greensburg, PA
National Provider Identifier
1295469922
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS0043921 Issued in PA
Practice address
121 Donohoe Rd
Greensburg, PA 15601-6986
Phone
(724) 836-1777
NPI assigned
Jul 9, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02906500 NJ
Dentist 122300000X DS0043921 PA Primary

Addresses

Primary practice location

121 Donohoe Rd
Greensburg, PA 15601-6986

Mailing address

525 Route 73 N Ste 104
Marlton, NJ 08053-3422
Phone (347) 393-2869

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

LicenseStateTypeSpecialty
22DI02906500NJMDDentist
DS0043921PAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Three Rivers Dental Group/Greensburg LLC CurrentSince Apr 30, 2023 Accepting new patients
Three Rivers Dental Group/Cranberry LLC Dentist PastSince Mar 1, 2023 Accepting new patients

Locations

121 Donohoe Rd
Greensburg, PA 15601
Phone (724) 836-1777

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1657324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1295469922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 ROUTE 73 N STE 104",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533422",
            "telephone_number": "347-393-2869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 DONOHOE RD",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156016986",
            "telephone_number": "724-836-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "YUSEOK",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-09",
        "last_updated": "2023-02-02",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02906500",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS0043921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.