Individual provider Active NPI

Charng-Shing Jean, D.M.D.

  • General Practice Dentistry
  • Irvine, CA
National Provider Identifier
1730260209
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D 33596 Issued in CA
Practice address
4200 Trabuco Rd
#130
Irvine, CA 92620-3600
Phone
(949) 551-4737
NPI assigned
Oct 18, 2006
Last updated
Nov 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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 D 33596 CA Primary

Addresses

Primary practice location

4200 Trabuco Rd
#130
Irvine, CA 92620-3600

Mailing address

12375 Fairbanks Dr
Tustin, CA 92782-1145
Phone (714) 669-9828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160121001323 CA Order and Referring Only - DentistPractitioner - Dentist 0042513210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D 33596CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Charng Shing Jean Dental Corporation General Practice CurrentSince Sep 11, 2022 Accepting new patients
Wang and Jean DMD Inc General Practice PastSince Mar 26, 2023 Accepting new patients

Locations

4200 Trabuco Rd
Ste 130
Irvine, CA 92620
Phone (949) 551-4737

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1730260209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12375 FAIRBANKS DR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927821145",
            "telephone_number": "714-669-9828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 TRABUCO RD",
            "address_2": "#130",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926203600",
            "telephone_number": "949-551-4737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN",
        "first_name": "CHARNG-SHING",
        "name_prefix": "Mr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "D 33596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.