Esther B. Jeong, DDS., PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

ESTHER B. JEONG, DDS., PLLC

Practice address

1125 W FM 544 Ste 700
Wylie, TX 75098-4958

Phone

(972) 881-0715

Fax

(972) 881-8521

NPI assigned

Dec 11, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Esther B. Jeong, DDS

Title

Owner/Dentist

Phone

(972) 881-0715

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1544486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544486400000",
    "number": "1871064162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 W FM 544 STE 700",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750984958",
            "telephone_number": "972-881-0715",
            "fax_number": "972-881-8521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 W FM 544 STE 700",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750984958",
            "telephone_number": "972-881-0715",
            "fax_number": "972-881-8521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESTHER B. JEONG, DDS., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-11",
        "last_updated": "2018-12-11",
        "status": "A",
        "authorized_official_last_name": "JEONG",
        "authorized_official_first_name": "ESTHER",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "972-881-0715",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "345294802",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "345294801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; 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.