Individual provider Active NPI

Jieun Jun, D.M.D.

  • General Practice Dentistry
  • Decatur, GA
National Provider Identifier
1619317518
Registry record updated Nov 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN014707 Issued in GA
Practice address
2450 Lawrenceville Hwy Ste 100
Decatur, GA 30033-3269
Phone
(404) 329-0000
NPI assigned
Jun 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN014707 GA Primary

Addresses

Primary practice location

2450 Lawrenceville Hwy Ste 100
Decatur, GA 30033-3269

Mailing address

2450 Lawrenceville Hwy Ste 100
Decatur, GA 30033-3269
Phone (404) 329-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20220301001420 GA Order and Referring Only - DentistPractitioner - Dentist 7214321611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN014707GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Alan J Stein DDS & David B Frankel DMD PC General Practice Past Accepting new patients

Organizations & group practices 1

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": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509926400000",
    "number": "1619317518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 LAWRENCEVILLE HWY STE 100",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333269",
            "telephone_number": "404-329-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 LAWRENCEVILLE HWY STE 100",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333269",
            "telephone_number": "404-329-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUN",
        "first_name": "JIEUN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2017-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN014707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.