Soong-Ryong Jung, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901019627 Issued in MI

Practice address

1910 Packard St Ste B
Ann Arbor, MI 48104-4734

Phone

(734) 478-7311

NPI assigned

Jun 18, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1629239132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4478 LAKE FOREST DR E",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481089684",
            "telephone_number": "734-214-0829",
            "fax_number": "313-576-1129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 PACKARD ST STE B",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044734",
            "telephone_number": "734-478-7311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7170 Preston Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750243381",
            "country_code": "US",
            "telephone_number": "972-618-8999",
            "fax_number": "972-208-0136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUNG",
        "first_name": "SOONG-RYONG",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-18",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "MI",
            "license": "2901019627",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Y. Lee DDS, PC
• Mary-Jo Marie Julin, DNP, RN, FNP-BC
• Marcy Ann Julvezan, CRNA
• Larry Richard Junck, MD
• Celeste Juneac
• Sun Min Jung, PHARM.D.
• Zachary Charles Junga, MD
• Andrea Jungwirth, M.D.
• Juniper Group Co, LLC
• Juniper North Health PLLC

• Dentist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; 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.