Active NPI
Weonsuk Jang, DMD
- General Practice Dentistry
- Citrus Heights, CA
National Provider Identifier
1972630374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 50473
- Practice address
- 6416 Tupelo Dr
Citrus Heights, CA 95621-1741 - Phone
- (916) 729-1441
- Fax
- (916) 729-1551
- NPI assigned
- Feb 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 50473 | CA | Primary |
Addresses
Primary practice location
6416 Tupelo Dr
Citrus Heights, CA 95621-1741
Mailing address
6416 Tupelo Dr
Citrus Heights, CA 95621-1741
Phone (916) 729-1441
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 |
|---|---|---|---|
| 50473 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Snow White Dental Office, Weonsuk Jang, D.M.D., Inc. | General Practice | 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.
-
- General Practice Dentistry
- Citrus Heights, CA
- NPI 1306035456
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972630374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6416 TUPELO DR",
"city": "CITRUS HEIGHTS",
"state": "CA",
"postal_code": "956211741",
"telephone_number": "916-729-1441",
"fax_number": "916-729-1551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6416 TUPELO DR",
"city": "CITRUS HEIGHTS",
"state": "CA",
"postal_code": "956211741",
"telephone_number": "916-729-1441",
"fax_number": "916-729-1551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANG",
"first_name": "WEONSUK",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "50473",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Citrus Heights, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.