Eun Sub Jang, D.D.S. Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48468 Issued in CA

Legal business name

EUN SUB JANG, D.D.S. INC

Practice address

95 Montgomery Dr
# 218
Santa Rosa, CA 95404-6630

Phone

(707) 545-3368

NPI assigned

May 29, 2007

Last updated

Aug 22, 2020By 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. Eun Sub Jang, D.D.S.

Title

Dentist

Phone

(707) 545-3368

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian C Lin, DDS

  • Dentist
  • Santa Rosa, CA
  • NPI 1184889958
  NPD (past)

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720289770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 MONTGOMERY DR",
            "address_2": "# 218",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954046630",
            "telephone_number": "707-545-3368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 MONTGOMERY DR",
            "address_2": "# 218",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954046630",
            "telephone_number": "707-545-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUN SUB JANG, D.D.S. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JANG",
        "authorized_official_first_name": "EUN SUB",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "707-545-3368",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "48468",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Alfredo Estrada
• Luz Estrada, RN
• Layna Etcheverry
• James Eubanks, MFT
• Eugene Belogorsky M.D. Inc
• Carla M Evans, FNP
• Charles Wayne Evans, M.D.
• Christopher Evans
• David Arland Evans
• Edward Theodore Evans, M.D.

• General Practice Dentistry in Santa Rosa, CA
• Providers in Santa Rosa, 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 Aug 22, 2020; 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.