Individual provider Active NPI

Wonseok Jang, DDS

  • Periodontics
  • New York, NY
National Provider Identifier
1306408588
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
062332 Issued in NY
Practice address
101 Lafayette St FL 9
New York, NY 10013-4153
Phone
(212) 842-5300
NPI assigned
Jul 8, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 062332 NY Primary

Addresses

Primary practice location

101 Lafayette St FL 9
New York, NY 10013-4153

Mailing address

101 Lafayette St FL 9
New York, NY 10013-4153
Phone (212) 842-5300

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
062332NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wonseok Jang Dentistry PLLC General Practice CurrentSince Aug 3, 2025 Accepting new patients
Lily W Eng Oliver, DDS, PLLC General Practice PastSince Aug 3, 2025 Accepting new patients

Locations

101 Lafayette St
Fl 9
New York, NY 10013
Phone (212) 233-5153

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": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1306408588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 LAFAYETTE ST FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134153",
            "telephone_number": "212-842-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 LAFAYETTE ST FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134153",
            "telephone_number": "212-842-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANG",
        "first_name": "WONSEOK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-08",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "062332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; 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.