State Family Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

57737 Issued in CA

Legal business name

STATE FAMILY DENTAL

Practice address

8928 State St
South Gate, CA 90280-2926

Phone

(323) 567-2995

Fax

(323) 567-2930

NPI assigned

Feb 9, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Noran Jeong, DDSNPI 1871743781

Title

President

Phone

(323) 567-2995

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Noran Jeong, D.D.S.

  • Dentist
  • South Gate, CA
  • NPI 1871743781
  NPD (past) Authorized official

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423440000000",
    "number": "1679964951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 N MARIPOSA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900042806",
            "telephone_number": "646-236-0717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8928 STATE ST",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902802926",
            "telephone_number": "323-567-2995",
            "fax_number": "323-567-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-09",
        "last_updated": "2015-02-09",
        "status": "A",
        "authorized_official_last_name": "JEONG",
        "authorized_official_first_name": "NORAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-567-2995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in South Gate, CA
• Providers in South Gate, 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 Feb 9, 2015; 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.