JUNG BAK DDS
NPI 1790958122
Dentist - General Practice in Los Angeles, CA
About Jung Bak Dds NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JUNG BAK DDS (NPI 1790958122) is an individual general practice provider in Los Angeles, California, licensed in California (56835) and active in the NPI registry since April 2008. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jung Bak Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jung Bak reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Sun Valley, CA 91352
- Reassigned Medicare billing, California enrollment
- 218 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 90042 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LOS ANGELES, CA 90042
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 Jung Bak's NPI number?
The NPI number for Jung Bak is 1790958122. It was assigned to this individual provider in the NPPES registry on April 7, 2008.
Where is Jung Bak located?
Jung Bak practices at 4080 Via Marisol Apt 341, Los Angeles, CA 90042. The listed phone number is (310) 702-4121.
What is Jung Bak's specialty?
The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.
Is Jung Bak enrolled in Medicare?
Yes. Jung Bak is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jung Bak's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jung Bak reassigns Medicare benefits to Northeast Valley Health Corporation (Sun Valley, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jung Bak's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jung Bak accept?
Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Humana list Jung Bak as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jung Bak was last updated on April 7, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.
# Jung Bak, DDS · NPI 1790958122
General Practice provider in Los Angeles, California. Individual provider, active in the CMS NPPES registry since April 7, 2008.
## Identity
- **NPI:** 1790958122 (Entity type: Individual)
- **Enumerated:** April 7, 2008
- **Primary specialty:** Dentist - General Practice · taxonomy 1223G0001X
- **State license:** 56835 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 4080 VIA MARISOL APT 341, Los Angeles, CA 90042-5159
- **Phone:** (310) 702-4121
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Northeast Valley Health Corporation (NPI 1013199264, Sun Valley, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 7, 2008
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Source: [NPI Profile](https://npiprofile.com/npi/1790958122) · Data from the CMS NPPES public registry.