JG Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

JG DENTAL PLLC

Practice address

4901 W Bell Rd Ste 140
Glendale, AZ 85308-3465

Phone

(623) 738-4904

NPI assigned

Oct 25, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Grace S Park, DDS

Title

Owner Manager

Phone

(623) 738-4904

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540425600000",
    "number": "1659848828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10111 N EL MIRAGE RD STE 4",
            "city": "EL MIRAGE",
            "state": "AZ",
            "postal_code": "853353605",
            "telephone_number": "623-738-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 W BELL RD STE 140",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083465",
            "telephone_number": "623-738-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JG DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-25",
        "last_updated": "2018-10-25",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER MANAGER",
        "authorized_official_telephone_number": "623-738-4904",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Eunhee Jeong, D.D.S.
• Jerrold K. Altman DMD,PC
• Indrajith Jetti
• David Jewett
• Jewish Family & Children'S Service
• Clara L Jimenez, LPC
• George Anthony Jimenez II, PHARMD
• Melissa Jimenez, SLPA
• Tricia L Jimenez, M.A., LPC
• Yamei Jing

• All providers in Glendale, AZ
• Dental Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.