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JI WOONG JEONG DDS
NPI 1053097543
Dentist - General Practice in Apo, AP

Active since June 27, 2023

NPPES record last updated: September 30, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ji Woong Jeong Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JI WOONG JEONG DDS (NPI 1053097543) is an individual general practice provider in Apo, AP, licensed in Massachusetts (DN10000820) and active in the NPI registry since June 2023.

NPPES Registry Identity

NPI1053097543
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameJI WOONG JEONGCredential: DDS
Location AddressUNIT 15245Apo, AP 96271-5245
Mailing AddressUnit 15245Apo, AP 96271-5245 · (315) 737-1411
Phone(315) 737-1411
Sole ProprietorNo
Enumeration DateJune 27, 2023
Last NPPES UpdateSeptember 30, 2025
NPPES CertifiedSeptember 30, 2025
✔ NPI 1053097543 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MA · DN10000820
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HYEON MYONG TSOU PARK
Physical Therapist
UNIT 15245
APO, AP 96271
No phone listed
WILLIAM TYLER BARTON DSC, PA-C
Emergency Medicine
UNIT 15245
APO, AP 96271
(315) 737-1411
JUNGMIN CHO D.M.D
Dentist (Pediatric Dentistry)
UNIT 15245
APO, AP 96271
(315) 737-9293
MS. SARAH KYUNGA AN ARNP
Nurse Practitioner
UNIT 15245
APO, AP 96271
(315) 737-4278
NA YEUN PARK BURKHOLDER NP
Nurse Practitioner (Family)
UNIT 15245
APO, AP 96271
(315) 737-2019
DORENE LUKE-WALTON
Pharmacist
UNIT 15245
APO, AP 96271
(315) 737-2022
DR. JOSEPH RAE PARK M.D.
Anesthesiology
UNIT 15245
APO, AP 96271
(315) 737-1341
MRS. MARY ELIZABETH CARMODY
Physician Assistant
UNIT 15245
APO, AP 96271
(315) 737-9387

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ji Woong Jeong's NPI number?

The NPI number for Ji Woong Jeong is 1053097543. It was assigned to this individual provider in the NPPES registry on June 27, 2023.

Where is Ji Woong Jeong located?

Ji Woong Jeong practices at Unit 15245, Apo, AP 96271. The listed phone number is (315) 737-1411.

What is Ji Woong Jeong's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Ji Woong Jeong was last updated on September 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.