Charles Jeong, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0479661 Issued in NY

Practice address

14205 Roosevelt Ave
134
Flushing, NY 11354-6045

Phone

(718) 762-1700

NPI assigned

Jul 16, 2007

Sex

Male

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

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Charles Jeong DDS

  • Oral and Maxillofacial Surgery Clinic/Center
  • Flushing, NY
  • NPI 1194385609
  NPD (past) Authorized official

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1669671970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14205 ROOSEVELT AVE",
            "address_2": "134",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546045",
            "telephone_number": "718-762-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14205 ROOSEVELT AVE",
            "address_2": "134",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546045",
            "telephone_number": "718-762-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEONG",
        "first_name": "CHARLES",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-16",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0479661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ing-Yann Jeng, M.D.
• Chan Hyeok Jeon, DDS
• Ji Won Jeon
• Jiyong Jeon, DPM
• Jeong Seo Acupunture, P.C.
• Julie Jeong
• Yunkyoung Jeong, NP
• Jerome D. Berman, M.D., P.C.
• Nicole Christine Jesnes, SLP
• Jessica Liang Acupuncture P.C.

• General Practice Dentistry in Flushing, NY
• Providers in Flushing, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.