Jae M Chong DMD PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JAE M CHONG DMD PC

Practice address

14215F Centreville SQ
Centreville, VA 20121-2301

Phone

(703) 825-1191

NPI assigned

Jul 30, 2024

Organization subpart

No

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

Authorized official

Name

Jae Chong, DMDNPI 1952314155

Title

President

Phone

(703) 825-1191

Specialties & licenses 1

Addresses

Other names 1

• Centreville Dental Design Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jae Min Chong, DMD

  • General Practice Dentistry
  • Centreville, VA
  • NPI 1952314155
  NPD Authorized official

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1831928654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14215F CENTREVILLE SQ",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212301",
            "telephone_number": "703-825-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14215F CENTREVILLE SQ",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212301",
            "telephone_number": "703-825-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAE M CHONG DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "CHONG",
        "authorized_official_first_name": "JAE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-825-1191",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centreville Dental Design",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jackson Clinics Limited Partnership
• Gracie Jackson
• Margaret Kay Jackson, OTR/L
• Noni Tene Jackson I
• Laura Elizabeth Jacobs, MS CCC-SLP
• Holly B Jahshan, DPT
• Ramatu Dougray Jalloh, PMHNP
• Asma Jamil, PA-C
• Jan Paul Fruiterman MD & Associates, PC
• Mary Heejoo Jang

• General Practice Dentistry in Centreville, VA
• Providers in Centreville, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.