Song W. Jung. DDS. Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SONG W. JUNG. DDS. INC

Doing business as

Christian Dental Arts

Practice address

23361 El Toro Rd, Ste 105
Lake Forest, CA 92630

Phone

(949) 458-1012

Fax

(949) 458-1013

NPI assigned

Oct 4, 2018

Last updated

Oct 4, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Song Woo Jung, D.D.S

Title

President

Phone

(949) 458-1012

Specialties & licenses 1

Addresses

Other names 1

• Christian Dental Arts Doing business as

Locations

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538611200000",
    "number": "1659846855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23361 EL TORO RD, STE 105",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "92630",
            "telephone_number": "949-458-1012",
            "fax_number": "949-458-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23361 EL TORO RD, STE 105",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "92630",
            "telephone_number": "949-458-1012",
            "fax_number": "949-458-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONG W. JUNG. DDS. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-04",
        "last_updated": "2018-10-04",
        "status": "A",
        "authorized_official_last_name": "JUNG",
        "authorized_official_first_name": "SONG WOO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-458-1012",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Christian Dental Arts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2018; 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.