David Jaekwan Jo, D.D.S., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

30682 Issued in CA

Practice address

3120 S Hacienda Blvd
Suite 205
Hacienda Heights, CA 91745-6305

Phone

(626) 330-3116

Fax

(626) 333-5607

NPI assigned

Jan 30, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• David J. Jo DDS Ms Inc.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Hacienda Heights, CA
  • NPI 1609919786
  NPD (past) Authorized official

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689711822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21655 STONEHAVEN DR",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928872631",
            "telephone_number": "714-779-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 S HACIENDA BLVD",
            "address_2": "SUITE 205",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917456305",
            "telephone_number": "626-330-3116",
            "fax_number": "626-333-5607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JO",
        "first_name": "DAVID",
        "middle_name": "JAEKWAN",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "30682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Hacienda Heights, CA
• Providers in Hacienda Heights, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.