CHANG WOO JUNG (NPI# 1245719780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245719780 |
| Entity Type | Individual |
| Full Name | CHANG WOO JUNG |
| Credential | DMD |
| Practice Address |
Bldg 38801 Academic Dr Suite B&c Ft Gordon GA 30905-5645 |
| Mailing Address |
7101 Hoff St Bldg 9240 Fort Benning GA 31905-5645 |
| Practice Telephone | 7067877050 |
| Mailing Telephone | 7065442051 |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2019-08-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019.031649 | IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467983957 | Chang Hoon Jung | Student in an Organized Health Care Education/Training Program | 101 The City Dr S, City Tower, Ste 400, Orange, CA 92868-3201 | 2017-03-25 |
| 1558582635 | Chang Sup Jung | Acupuncturist | 1920 Saint Andrews Dr, Seal Beach, CA 90740-5503 | 2007-05-02 |
| Street Address |
BLDG 38801 ACADEMIC DR SUITE B&C |
| City | FT GORDON |
| State | GA |
| Zip Code | 30905-5645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831175769 | Crystal Jo Smith | Dentist | Bldg 38801 Academic Dr, Suite B & C, Ft Gordon, GA 30905-5660 | 2005-12-22 |
| 1760038046 | Jimmy Nmn Chen | Dentist | Bldg 38801 Academic Dr, Suite B&c, Ft Gordon, GA 30905-5660 | 2019-08-13 |
| 1942759501 | Lisa Ann Harwell | Dental Assistant | Bldg 38801 Academic Dr, Suite B & C, Ft Gordon, GA 30905-5660 | 2016-09-23 |
| 1851730923 | Daniel Bradley Bruin | Dentist | Bldg 38801 Academic Dr, Suite B&c, Ft Gordon, GA 30905-5660 | 2013-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417508995 | Priscilla Denise Brown | Prosthetic/Orthotic Supplier | 38200 3rd Ave, Fort Gordon, GA 30905 | 2019-09-25 |
| 1740754308 | Patricia Lynn Blevins | Nurse Practitioner | 300 E Hospital Dr, Augusta, GA 30905 | 2019-01-17 |
| 1861971335 | Isabella Anderson | Dentist | Usa Dental Activity, Hospital Dental Clinic, Bldg 38801 Academic, Ste B&c, Ft Gordon, GA 30905 | 2018-08-07 |
| 1972097426 | Cortney Wolfley | Student in an Organized Health Care Education/Training Program | Orthopaedics Ddeamc, 300 East Hospital Road, Fort Gordon, GA 30905 | 2018-06-19 |
| 1003337536 | David Jonathon Sabovich | Dentist | 38801 Academic Dr Ste B&cactivity, Suite B & C, Ft Gordon, GA 30905 | 2017-07-06 |
| 1437689411 | Marcos Aranda | Student in an Organized Health Care Education/Training Program | General Surgery, Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 | 2017-06-13 |
| 1659809846 | Brian Kevin Burke | Student in an Organized Health Care Education/Training Program | 300 East Hosptial Road, Fort Gordon, GA 30905 | 2017-06-01 |
| 1902334469 | Jacqueline Renee Mulhall | Student in an Organized Health Care Education/Training Program | Ddeamc, 300 E Hospital Rd, General Surgery, Fort Gordon, GA 30905 | 2017-05-30 |
| 1750837456 | Amanda R Bailey | Internal Medicine | 300 E. Hospital Dr., Fort Gordon, GA 30905 | 2016-09-01 |
| 1689120016 | Thomas S Moffitt | Internal Medicine | Im, Dwight D Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 | 2016-08-26 |
| Find all providers in zip 30905 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073670550 | Travis James Austin | Dentist | Bldg 38801 Academic Dr Ste B,c, Usa Dentac, Ft Gordon, GA 30905 | 2007-01-03 |
| 1588641864 | Johnette Joy Shelley | Dentist | Bldg 38717, 38th St, Usa Dentac, Ft Gordon, GA 30905-5660 | 2005-12-28 |
| 1104803741 | Hwahoon Jeong | Dentist | Usa Dental Health Activity (dha), Bldg 38801 Academic Dr, Ste B&c, Ft Gordon, GA 30905-5660 | 2005-12-26 |
| 1831175769 | Crystal Jo Smith | Dentist | Bldg 38801 Academic Dr, Suite B & C, Ft Gordon, GA 30905-5660 | 2005-12-22 |
| 1669456828 | William Wayne Carmichael | Dentist | Bldg 38717 38 St., Attn: Credentials Office, Ft Gordon, GA 30905-5660 | 2005-12-01 |
| 1760038046 | Jimmy Nmn Chen | Dentist | Bldg 38801 Academic Dr, Suite B&c, Ft Gordon, GA 30905-5660 | 2019-08-13 |
| 1518414630 | James Patrick Wilson | Dentist | Bldg 38801 Academic Dr, Suite B & C, Usa Dentac, Ft Gordon, GA 30905-5660 | 2016-09-07 |
| 1447669023 | Andrew Clanney | Dentist | Bldg 38717 38th Street, Usa Dentac, Ft Gordon, GA 30905-5660 | 2014-08-07 |
| 1245648351 | Spencer Hill | Dentist | Bldg 38717 38th Street, Usa Dentac, Ft Gordon, GA 30905-5660 | 2014-08-01 |
| 1992113062 | Martin Smallidge | Dentist | 38717 38th Street, Usa Dentac, Ft Gordon, GA 30905-5660 | 2014-08-01 |
| Find all providers in FT GORDON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.