Individual provider Active NPI

Jenny S Cheung, D.D.S.

  • General Practice Dentistry
  • Manassas, VA
National Provider Identifier
1780644153
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401411412 Issued in VA
Practice address
9003 Church St
Manassas, VA 20110-5410
Phone
(703) 369-2323
Fax
(703) 369-4854
NPI assigned
Mar 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13697 MD
General Practice Dentistry 1223G0001X 0401411412 VA Primary

Addresses

Primary practice location

9003 Church St
Manassas, VA 20110-5410

Mailing address

43350 Juniper Glen Dr
Chantilly, VA 20152-1969
Phone (443) 691-2938

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
13697MDMDGeneral Practice Dentistry
0401411412VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ea Dental General Practice Current Accepting new patients
Reston Dental Care PC General Practice Past Accepting new patients

Locations

11345 Sunset Hills Rd
Reston, VA 20190
Phone (703) 689-0110

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780644153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43350 JUNIPER GLEN DR",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201521969",
            "telephone_number": "443-691-2938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9003 CHURCH ST",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201105410",
            "telephone_number": "703-369-2323",
            "fax_number": "703-369-4854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEUNG",
        "first_name": "JENNY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "13697",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401411412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.