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General NPI Number Information
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NPI Number | 1801716097
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Entity Type | Organization
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Legal Business Name | JINWOO JEONG DENTAL CORPORATION
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Dates
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Enumeration Date | 07/17/2026
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Last Update Date | 07/17/2026
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Provider Practice Location Address
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Address Line | 39560 STEVENSON PL STE 219
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City | FREMONT
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State | CA
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Zip | 94539-3074
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Country | US
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Telephone | 510-794-9999
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Fax |
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Provider Business Mailing Address
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Address Line | 38340 PRINCETON TER # 5
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City | FREMONT
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State | CA
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Zip | 94538-1739
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Country | US
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Telephone | 847-715-8182
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JINWOO JEONG
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Credential | DMD
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Telephone | 847-715-8182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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