MEDICARE: JONATHANE SOO JEON D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	22DI01707100	NJ

General Provider Information

NPI Number	:	1609048701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHANE SOO JEON D.D.S.

Provider Business Mailing Address
First Line	:	1585 PALISADE AVE
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-6931
Country	:	US
Telephone Number	:	201-585-9392
Fax Number	:

Provider Business Practice Location Address
First Line	:	1585 PALISADE AVE
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-6931
Country	:	US
Telephone Number	:	201-585-9392
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2008
Last Update Date	:	03/28/2008

Similar Medicare Providers

1598937609 — SHERIF S RADWAN D.D.S.
Practice Location Address:

1585 PALISADE AVE
FORT LEE, NJ
07024-6931

Practice Phone: 201-947-9494
Practice Fax:

1255844569 — LOHAS ACUPUNCTURE AND HERBS LLC
Practice Location Address:

1579 PALISADE AVE FL 2
FORT LEE, NJ
07024-6931

Practice Phone: 201-815-7070
Practice Fax: 201-585-7070

1386201747 — GLORIA LAMPREA-DURAN FNP
Practice Location Address:

1585 PALISADE AVE
FORT LEE, NJ
07024-6931

Practice Phone: 201-292-1590
Practice Fax:

1285589374 — PALMER SKUDNESKI MFTC
Practice Location Address:

3332 W PROSPECT RD
FORT COLLINS, CO
80526-6931

Practice Phone: 720-236-7001
Practice Fax:

1457595100 — ANN MARIE BROWN R.N.
Practice Location Address:

13021 SHORESIDE CT
FORT MYERS, FL
33913-6931

Practice Phone: 619-379-4488
Practice Fax:

1164740197 — ELIZABETH A JARRETT ATC
Practice Location Address:

937 HICKORY STICK DR
FORT MILL, SC
29715-6931

Practice Phone: 317-490-4416
Practice Fax:

Directions to “ JONATHANE SOO JEON D.D.S.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.