Walter J. Jung Professional Dental Corporation

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

5295 Issued in LA

Legal business name

WALTER J. JUNG PROFESSIONAL DENTAL CORPORATION

Practice address

8680 Bluebonnet Blvd
Suite C
Baton Rouge, LA 70810-7825

Phone

(225) 767-7212

Fax

(225) 767-0945

NPI assigned

Mar 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Walter J Jung, DDS, PC

Title

Owner

Phone

(225) 767-7212

Specialties & licenses 1

Addresses

Other names 1

• Southern Louisiana Oral & Maxillofacial Surgery Doing business as

Locations

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1659404077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8680 BLUEBONNET BLVD",
            "address_2": "SUITE C",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708107825",
            "telephone_number": "225-767-7212",
            "fax_number": "225-767-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8680 BLUEBONNET BLVD",
            "address_2": "SUITE C",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708107825",
            "telephone_number": "225-767-7212",
            "fax_number": "225-767-0945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER J. JUNG PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2008-07-17",
        "status": "A",
        "authorized_official_last_name": "JUNG",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-767-7212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, PC"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "LA",
            "license": "5295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Louisiana Oral & Maxillofacial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nancy McMorris Walls, RN, MSN, FNP
• Douglas Christopher Walsh, M.D.
• Kathleen Walsh, OT
• Laura Doolittle Walsh, PA-C
• Summer Nicole Walsh
• Walter Wright Ellis, LLC
• Latonya Walter
• Nancy Walter
• Arianna Walters
• Carey Ellender Walters, M.S.W., L.C.S.W.

• Oral and Maxillofacial Surgery (Dentist) in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; 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.