Individual provider Active NPI

Jillwen Sung, D.M.D.

  • Endodontics
  • Houston, TX
National Provider Identifier
1548479710
Registry record updated Nov 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
22073 Issued in TX
Practice address
6918 Corporate Dr
Suite a-11
Houston, TX 77036-5112
Phone
(713) 271-7878
NPI assigned
May 22, 2007
Last updated
Nov 14, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 050526 NY
Endodontics 1223E0200X 22073 TX Primary

Addresses

Primary practice location

6918 Corporate Dr
Suite a-11
Houston, TX 77036-5112

Mailing address

6918 Corporate Dr
Suite a-11
Houston, TX 77036-5112
Phone (713) 271-7878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160420000693 TX Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 3870891153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
050526NYMDEndodontist
22073TXMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289692800000",
    "number": "1548479710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6918 CORPORATE DR",
            "address_2": "SUITE A-11",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770365112",
            "telephone_number": "713-271-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6918 CORPORATE DR",
            "address_2": "SUITE A-11",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770365112",
            "telephone_number": "713-271-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNG",
        "first_name": "JILLWEN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2010-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "050526",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "22073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.