Daniel Jeong, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN1855177 Issued in MA

Practice address

1201 Main St
Tewksbury, MA 01876-4774

Phone

(978) 851-5200

NPI assigned

Apr 29, 2008

Last updated

Nov 8, 2021By the provider in NPPES

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Feb 21, 2020 through Feb 21, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Surgical Associates, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Tewksbury, MA
  • NPI 1750422762
  NPD (past)
• Renew Dental P C

  • Oral and Maxillofacial Surgery (Dentist)
  • Tewksbury, MA
  • NPI 1407454523
  NPD (past)

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1922273036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 MAIN ST",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018764774",
            "telephone_number": "978-851-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 MAIN ST",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018764774",
            "telephone_number": "978-851-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEONG",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-29",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "DN1855177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrity Home Care Solutions, LLC
• Cheryl Jacobs, LICSW
• Rosemary C. Janas, FNP
• Adam Thomas Jankowski
• Adjoavi Jean-Laurent, RPH
• JFB Distributors & Delivery Services Inc
• John H. Heckler, P.C.
• John L Guerin D.M.D PC
• Dorothea M. Johnson, P.T.A.
• Heather A Jones Millette

• Oral and Maxillofacial Surgery (Dentist) in Tewksbury, MA
• Providers in Tewksbury, MA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; 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.