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General NPI Number Information
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NPI Number | 1609372598
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Entity Type | Individual
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Provider Name | JENNY JAEHEE JEON DDS, MS
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Gender | Female
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Dates
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Enumeration Date | 04/01/2018
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Last Update Date | 06/23/2021
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Provider Practice Location Address
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Address Line | 7925 SEVILLE AVE
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-7000
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Country | US
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Telephone | 844-757-9799
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 S SERRANO AVE APT 514
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City | LOS ANGELES
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State | CA
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Zip | 90006-3872
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Country | US
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Telephone | 949-812-8540
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 105277
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN23879
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN23879
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 105277
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License Number State | CA
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