Active NPI
Yun Joo Jung, DDS
- Dentist
- Rockville, MD
National Provider Identifier
1962780817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 16736
- Practice address
- 15200 Shady Grove Rd Ste 105
Rockville, MD 20850-3218 - Phone
- (301) 330-9644
- NPI assigned
- Jul 26, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 16736 | MD | Primary |
Addresses
Primary practice location
15200 Shady Grove Rd Ste 105
Rockville, MD 20850-3218
Mailing address
15200 Shady Grove Rd Ste 105
Rockville, MD 20850-3218
Phone (301) 330-9644
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16736 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dlight Dental | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613001600000",
"number": "1962780817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15200 SHADY GROVE RD STE 105",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208503218",
"telephone_number": "301-330-9644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15200 SHADY GROVE RD STE 105",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208503218",
"telephone_number": "301-330-9644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUNG",
"first_name": "YUN JOO",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-26",
"last_updated": "2021-02-11",
"certification_date": "2021-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "16736",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.