JL Dental Group LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

JL DENTAL GROUP LLC

Practice address

919 W Kirby Ave
Champaign, IL 61821-5121

Phone

(217) 359-2500

NPI assigned

Jun 29, 2022

Organization subpart

Yes

Parent organization

JL DENTAL GROUP LLCAs reported in NPPES

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

Authorized official

Name

Dr. Kwunho Jung, DDSNPI 1013368943

Title

Owner

Phone

(217) 722-6415

Specialties & licenses 1

Addresses

Other names 1

• Q Dental Doing business as

Tax ID family

JL Dental Group2 organizations share this tax ID, including this one

Part of

JL Dental Group

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• JL Dental Group

  • Dental Clinic/Center
  • Champaign, IL
  • NPI 1912644022
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• JL Dental Group

  • Dental Clinic/Center
  • Champaign, IL
  • NPI 1912644022
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kwunho K Jung, D.M.D.

  • General Practice Dentistry
  • Charleston, IL
  • NPI 1013368943
  NPD Authorized official

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656460800000",
    "number": "1477285385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 W KIRBY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618215121",
            "telephone_number": "217-359-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 W KIRBY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618215121",
            "telephone_number": "217-359-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JL DENTAL GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JL DENTAL GROUP LLC",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A",
        "authorized_official_last_name": "JUNG",
        "authorized_official_first_name": "KWUNHO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-722-6415",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Q Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tiffany Keisha Jenkins, PHD, NCSP
• Amy Jessup, NP
• Jim Hamilton Counseling and Therapy Company
• Prapis Jisook, NP
• JL Dental Group
• Terrance Richard Jobin, LCSW
• Tiffany Renee Johnson-Bey
• Beth A Johnson, MA CCC SLP L
• Carolyn Nicole Johnson, LSW
• Christine Johnson, LCPC

• Dental Clinic/Center in Champaign, IL
• Providers in Champaign, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; 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.