Active NPI
Jennifer Y Sung, D.D.S.
- General Practice Dentistry
- Brooklyn, NY
National Provider Identifier
1295961787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 054962-1
- Practice address
- 800 Poly PL
Dental Service 160
Brooklyn, NY 11209-7104 - Phone
- (718) 630-3650
- NPI assigned
- Jun 10, 2009
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 054962-1 | NY | Primary |
Addresses
Primary practice location
800 Poly PL
Dental Service 160
Brooklyn, NY 11209-7104
Mailing address
800 Poly PL
Brooklyn, NY 11209-7104
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151230002256 | NY | Order and Referring Only - Oral Surgery | 3971823451 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 054962-1 | NY | MD | General Practice Dentistry |
| 054962 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280188800000",
"number": "1295961787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 POLY PL",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112097104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 POLY PL",
"address_2": "DENTAL SERVICE 160",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112097104",
"telephone_number": "718-630-3650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUNG",
"first_name": "JENNIFER",
"middle_name": "Y",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-10",
"last_updated": "2010-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "054962-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; 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.