Sungmin Peter Jeoun, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401414949 Issued in VA

Practice address

616 Virginia Beach Blvd
#102
Virginia Beach, VA 23451-4274

Phone

(757) 769-7155

NPI assigned

Mar 16, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 10, 2016 through Jun 10, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dental Anesthesia Services, Llc331

  • Dental Clinic/Center
  • Virginia Beach, VA
  • NPI 1598043739
  NPD (past)
• Katdel LLC

  • General Practice Dentistry
  • Chesapeake, VA
  • NPI 1073186656
  NPD (past)

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

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1881087740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 VIRGINIA BEACH BLVD",
            "address_2": "#102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234514274",
            "telephone_number": "757-769-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 VIRGINIA BEACH BLVD",
            "address_2": "#102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234514274",
            "telephone_number": "757-769-7155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEOUN",
        "first_name": "SUNGMIN",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-16",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401414949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Jennings II, PH.D.
• Heather Jennings
• Jessica L Jennings, LPC, ADC
• Megan Jennings
• Margaret Jean (Peg) Jensen, PH.D., LPC
• Jessica Jill Jeremiah, OTR/L
• Paris Jeremiah
• Jeremy B. Davidson DDS PC
• Jeremy Shulman
• Jerious Counseling Services, LLC

• General Practice Dentistry in Virginia Beach, VA
• Providers in Virginia Beach, 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 Feb 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.