Jonathane Soo Jeon, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

22DI01707100 Issued in NJ

Practice address

1585 Palisade Ave
Fort Lee, NJ 07024-6931

Phone

(201) 585-9392

NPI assigned

Mar 28, 2008

Last updated

Mar 28, 2008By 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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1206662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206662400000",
    "number": "1609048701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 PALISADE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246931",
            "telephone_number": "201-585-9392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 PALISADE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246931",
            "telephone_number": "201-585-9392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEON",
        "first_name": "JONATHANE",
        "middle_name": "SOO",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-28",
        "last_updated": "2008-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "22DI01707100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Star Corporation (Star Pharmacy)
• Eunjeong Jang
• Sungkoo Jang, DDS
• Ye Jin Jang, BCBA
• Jeffrey M. Ahn, M.D., P.C.
• Sooyeon Jeong
• Louis Jerome, DMD
• Jersey Stake LLC (Visiting Angels of Fort Lee)
• Jigsaw Diagnostics New Jersey PC
• David Jin, D.D.S.

• Orthodontics and Dentofacial Orthopedics Dentistry in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; 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.