Healthcare Provider Details

I. General information

NPI: 1033804927
Provider Name (Legal Business Name): DANIEL WOOJIN JANG DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2023
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6535 CHARLES SNIDER RD
LOVELAND OH
45140-9588
US

IV. Provider business mailing address

424 WARDS CORNER RD STE 200
LOVELAND OH
45140-6966
US

V. Phone/Fax

Practice location:
  • Phone: 513-575-1444
  • Fax: 513-575-1451
Mailing address:
  • Phone: 513-707-4041
  • Fax: 513-576-1020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34018754
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: