NPIMap

Individual provider Active NPI

Eugene Jang, DDS

  • General Practice Dentistry
  • Baltimore, MD
National Provider Identifier
1720560733
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16640 Issued in MD
Practice address
5710 Bellona Ave Ste 101
Baltimore, MD 21212-3500
Phone
(410) 323-2875
NPI assigned
Sep 6, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 16640 MD Primary

Addresses

Primary practice location

5710 Bellona Ave Ste 101
Baltimore, MD 21212-3500

Mailing address

5710 Bellona Ave Ste 101
Baltimore, MD 21212-3500
Phone (410) 323-2875

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Allison & Eugene Jang DDS LLC General Practice Current Accepting new patients
First Dental CurrentSince Sep 5, 2023 Accepting new patients
George Xenakis, DDS, Maryland, LLC Past Accepting new patients

Locations

5710 Bellona Ave
Ste 101
Baltimore, MD 21212
Phone (410) 323-2875

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1720560733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5710 BELLONA AVE STE 101",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212123500",
            "telephone_number": "410-323-2875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5710 BELLONA AVE STE 101",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212123500",
            "telephone_number": "410-323-2875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANG",
        "first_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-06",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "16640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.