Individual provider Active NPI

Jonathan Jang, DDS

  • General Practice Dentistry
  • Plant City, FL
National Provider Identifier
1740924539
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN29707 Issued in FL
Practice address
1708 S Alexander St
Plant City, FL 33563
Phone
(813) 752-5600
NPI assigned
Apr 26, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X DN29707 FL Primary

Addresses

Primary practice location

1708 S Alexander St
Plant City, FL 33563

Mailing address

1 Gustave L Levy PL # 1187
New York, NY 10029-6504

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

State licenses

LicenseStateTypeSpecialty
DN29707FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Dental Designs CurrentSince Jan 12, 2025 Accepting new patients

Locations

1708 S Alexander St
Plant City, FL 33563
Phone (813) 686-9300

Organizations & group practices 1

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": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1740924539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL # 1187",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 S ALEXANDER ST",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "33563",
            "telephone_number": "813-752-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANG",
        "first_name": "JONATHAN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-26",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN29707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plant City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.