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NPI Code Detail

MEDICARE: DR. YOUNG SOO JANG I D.M.D

MEDICARE:  DR. YOUNG SOO JANG I D.M.D
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
11223G0001XGeneral Practice DentistryDS030832LPA

General Provider Information

NPI Number : 1881927887
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. YOUNG SOO JANG I D.M.D
Provider Business Mailing Address
First Line : 7300 OLD YORK RD
Second Line : 211
City : ELKINS PARK
State : PA
Zip : 19027-3037
Country : US
Telephone Number : 215-782-1606
Fax Number : 215-782-1605
Provider Business Practice Location Address
First Line : 7300 OLD YORK RD
Second Line : 211
City : ELKINS PARK
State : PA
Zip : 19027-3037
Country : US
Telephone Number : 215-782-1606
Fax Number : 215-782-1605
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2009
Last Update Date : 06/21/2016

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