Jong Um, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

106062 Issued in CA

Practice address

5001 Cerritos Ave Ste a
Cypress, CA 90630-4570

Phone

(860) 325-0022

NPI assigned

Jun 13, 2014

Last updated

May 26, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Dec 19, 2022 through Dec 19, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• J Um DDS Cypress

  • Dental Clinic/Center
  • Cypress, CA
  • NPI 1225603616
  NPD Authorized official
• Jong Um DDS, Inc

  dba Same Day Dental PA

  • General Practice Dentistry
  • Fort Myers, FL
  • NPI 1104204445
  Authorized official Same address or phone
• Jong Um DDS, Inc

  dba D & L Dental Associates

  • General Practice Dentistry
  • Fairfield, CT
  • NPI 1265803431
  Authorized official Same address or phone
• Tender Dental Bonanaza, LLC

  • General Practice Dentistry
  • Las Vegas, NV
  • NPI 1124556741
  Authorized official Same address or phone
• Tender Dental Management, LLC

  • General Practice Dentistry
  • Las Vegas, NV
  • NPI 1104356187
  Authorized official Same address or phone

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

{
    "created_epoch": "1402617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1720492184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 CERRITOS AVE STE A",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906304570",
            "telephone_number": "860-325-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 CERRITOS AVE STE A",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906304570",
            "telephone_number": "860-325-0022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Sherman Ct",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CT",
            "postal_code": "068245825",
            "country_code": "US",
            "telephone_number": "203-255-0108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5001 E Bonanza Rd Ste 160",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891103560",
            "country_code": "US",
            "telephone_number": "860-325-0022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UM",
        "first_name": "JONG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-13",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "011496",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "6883",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "106062",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 20702",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Ann Turner
• Tustin Urgent Care, Apc (Xpress Urgent Care Cypress)
• Jessica Marilyn Tuttle
• Mary Ann Jinky Twaddell, DMD
• Kathryn M Tynan, NP
• Ki M Um, DDS
• United Physicians International, Inc.
• University Foot and Ankle Institute a Podiatric Surgical Center
• Chinenye Utom
• Meghann Katherine Valencia, M.S.

• Dentist in Cypress, CA
• Providers in Cypress, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.