Jae Min Chong, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401411488 Issued in VA

Practice address

14215F Centreville SQ
Centreville, VA 20121-2301

Phone

(703) 825-1191

Fax

(703) 825-7356

NPI assigned

Aug 15, 2006

Last updated

Jul 30, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• J Chong DMD & Associates PC

  dba Herndon Dental Design

  • General Practice Dentistry
  • Herndon, VA
  • NPI 1598594319
  NPD Authorized official
• Jae M Chong DMD PC

  dba Centreville Dental Design

  • General Practice Dentistry
  • Centreville, VA
  • NPI 1831928654
  NPD Authorized official
• Skyline Dental P.C.

  dba Family Dental Center of Tysons, P.C

  • General Practice Dentistry
  • Dunn Loring, VA
  • NPI 1205560802
  NPD (past)
• Sun Ok Suk, DDS, PC

  • Dental Clinic/Center
  • Dunn Loring, VA
  • NPI 1689006629
  NPD (past)

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1952314155",
    "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",
            "fax_number": "703-825-7356"
        },
        {
            "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",
            "fax_number": "703-825-7356"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "131 Elden St Ste 140",
            "address_purpose": "LOCATION",
            "city": "Herndon",
            "state": "VA",
            "postal_code": "201704835",
            "country_code": "US",
            "telephone_number": "703-989-6283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHONG",
        "first_name": "JAE",
        "middle_name": "MIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401411488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loan Chin, PHARMD
• Sophie Faithlynn Chmielewski
• Yon S Choe, L.AC., M.AC.
• Bokyu Choi, D.M.D.
• Yunsuk Choi
• John Yohan Chong, M.D.
• Christine Hart Kress DNP, PLLC
• Young Imkim Chu, ACUPUNCTURIST
• Shue Jen Chuang, D.D.S.
• Eunhwa Chun, RPH

• 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 Jul 30, 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.