Individual provider Active NPI

Sung Min Jung, DMD

  • General Practice Dentistry
  • Kirkland, WA
National Provider Identifier
1427630557
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
61067957 Issued in WA
Practice address
12911 120TH Ave NE Ste A10
Kirkland, WA 98034-3074
Phone
(425) 941-0013
NPI assigned
Apr 27, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 61067957 WA Primary

Addresses

Primary practice location

12911 120TH Ave NE Ste A10
Kirkland, WA 98034-3074

Mailing address

12911 120TH Ave NE Ste A10
Kirkland, WA 98034-3074
Phone (425) 941-0013

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
61067957WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sung M Jung, DMD, PLLC General Practice CurrentSince Aug 25, 2025 Accepting new patients

Locations

12911 120th Ave NE
Ste A10
Kirkland, WA 98034
Phone (425) 821-1188

Organizations & group practices 1

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": "1619481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1427630557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12911 120TH AVE NE STE A10",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343074",
            "telephone_number": "425-941-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12911 120TH AVE NE STE A10",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343074",
            "telephone_number": "425-941-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "SUNG",
        "middle_name": "MIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-27",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "61067957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.