Active NPI
Justin Jang
- General Practice Dentistry
- Santa Fe Springs, CA
National Provider Identifier
1629762554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DDS113162
- Practice address
- 13327 Florence Ave
Santa Fe Springs, CA 90670-2127 - Phone
- (562) 232-4715
- NPI assigned
- Jun 5, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DDS113162 | CA | Primary |
Addresses
Primary practice location
13327 Florence Ave
Santa Fe Springs, CA 90670-2127
Mailing address
351 Lido Way
Brea, CA 92821-2156
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Santa Fe Springs Modern Dentistry, Inc | General Practice | Past | Accepting new patients |
Interoperability endpoints
- justin.jang.p1@direct.aihs.nextgenshare.com
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.
-
- General Practice Dentistry
- Santa Fe Springs, CA
- NPI 1356149009
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783296000000",
"number": "1629762554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "351 LIDO WAY",
"city": "BREA",
"state": "CA",
"postal_code": "928212156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13327 FLORENCE AVE",
"city": "SANTA FE SPRINGS",
"state": "CA",
"postal_code": "906702127",
"telephone_number": "562-232-4715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANG",
"first_name": "JUSTIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-06-05",
"last_updated": "2026-07-06",
"certification_date": "2026-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "DDS113162",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Fe Springs, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.