Individual provider Active NPI

Seung Min Jung

  • General Practice Dentistry
  • Buena Park, CA
National Provider Identifier
1629516539
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS104956 Issued in CA
Practice address
35 Windward Way
Buena Park, CA 90621-1683
Phone
(718) 710-1275
NPI assigned
Feb 10, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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 DDS104956 CA Primary

Addresses

Primary practice location

35 Windward Way
Buena Park, CA 90621-1683

Mailing address

35 Windward Way
Buena Park, CA 90621-1683
Phone (718) 710-1275

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS104956CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Seung Min Jung DDS, Inc CurrentSince Jul 9, 2025 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": "1486684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1629516539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 WINDWARD WAY",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906211683",
            "telephone_number": "718-710-1275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 WINDWARD WAY",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906211683",
            "telephone_number": "718-710-1275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "SEUNG MIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-10",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS104956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buena Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; 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.