Individual provider Active NPI

Eunice Y Jung, DDS

  • Dentist
  • Nesconset, NY
National Provider Identifier
1609385590
Registry record updated Oct 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
060816 Issued in NY
Practice address
239 Smithtown Blvd
Nesconset, NY 11767-2418
Phone
(631) 724-0094
NPI assigned
Sep 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 101763 CA
Dentist 122300000X 060816 NY Primary

Addresses

Primary practice location

239 Smithtown Blvd
Nesconset, NY 11767-2418

Mailing address

211 Horseblock Rd
Farmingville, NY 11738-1236
Phone (530) 574-3053

Other practice location 1

1240 Scott Blvd
Santa Clara, CA 95050-4517
Phone (408) 246-0300

Other practice location 2

1879 Route 112
Coram, NY 11727-2256
Phone (631) 474-0410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
101763CAMDClinical Social Worker
060816NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Nesconset Dental Associates PastSince Oct 13, 2019 Accepting new patients
Nesconset Dental Associates PastSince Oct 13, 2019 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1506211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1609385590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 HORSEBLOCK RD",
            "city": "FARMINGVILLE",
            "state": "NY",
            "postal_code": "117381236",
            "telephone_number": "530-574-3053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 SMITHTOWN BLVD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117672418",
            "telephone_number": "631-724-0094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1240 Scott Blvd",
            "address_purpose": "LOCATION",
            "city": "Santa Clara",
            "state": "CA",
            "postal_code": "950504517",
            "country_code": "US",
            "telephone_number": "408-246-0300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1879 Route 112",
            "address_purpose": "LOCATION",
            "city": "Coram",
            "state": "NY",
            "postal_code": "117272256",
            "country_code": "US",
            "telephone_number": "631-474-0410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUNG",
        "first_name": "EUNICE",
        "middle_name": "Y",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-24",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "101763",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "060816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nesconset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; 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.