Jin Young Maeng, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019028795 Issued in IL

Practice address

1300 N Ashland Ave FRNT 123a
Chicago, IL 60622-2268

Phone

(773) 819-7724

Fax

(773) 819-7725

NPI assigned

Jul 25, 2011

Last updated

Sep 10, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ash Dental PC

  dba all star dental clinic

  • Dentist
  • Chicago, IL
  • NPI 1053584599
  NPD (past)

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

{
    "created_epoch": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1578841540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N ASHLAND AVE FRNT 123A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222268",
            "telephone_number": "773-819-7724",
            "fax_number": "773-819-7725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N ASHLAND AVE FRNT 123A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222268",
            "telephone_number": "773-819-7724",
            "fax_number": "773-819-7725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAENG",
        "first_name": "JIN YOUNG",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-25",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madvitality Acupuncture & Wellness PLLC
• Venkatgiri S Mady, M.D.
• Mae's Quality Home Care LLC
• Audrey D Mael, OTR/L
• David M Mael, M.D.
• Katherine Elizabeth Maes, PT
• Robert Adam Jesus Maes, RDN, LDN
• Alyssa Maestre, LSW, LCSW
• Mustafa Anwer Jasim Mafraji, MBBS
• Nadia Claudia Maftei

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.

Verify at the official NPI Registry.