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

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 and National Provider Directory roles.

• Ash Dental PC

  • 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

• All providers in Chicago, IL
• 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.