Ha Ra Jeon, DDS

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

101866 Issued in CA

Practice address

2492 Walnut Ave Ste 200
Tustin, CA 92780-6960

Phone

(949) 679-6000

Fax

(949) 679-6001

NPI assigned

Oct 9, 2019

Sex

Female

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

Practice roles

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.

• Keon-Jung Kim Dental Corporation

  • Dental Clinic/Center
  • Tustin, CA
  • NPI 1932315298
  NPD (past)

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1629610738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2492 WALNUT AVE STE 200",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806960",
            "telephone_number": "949-679-6000",
            "fax_number": "949-679-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2492 WALNUT AVE STE 200",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806960",
            "telephone_number": "949-679-6000",
            "fax_number": "949-679-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEON",
        "first_name": "HA RA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-09",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "CA",
            "license": "101866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• JDB Speech Language Services
• Jacqueline Lily Jebavy
• Maxwell Jen, MD
• Nora M Jennings, MFT
• Jennifer Laura Jenrette, MSW
• Jera Wellness Acupuncture
• Jerry K Wu DMD Inc
• Jerry L. Morris, M.D., Inc.
• Jerry Lee Morris MD Inc
• Elisa Victoria Jiang, REGISTERED OTR

• Public Health Dentistry in Tustin, CA
• Providers in Tustin, CA by specialty
• Public Health Dentistry in California

• 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.