SEUNGHYUN JAE (NPI# 1184008708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184008708 |
| Entity Type | Individual |
| Full Name | SEUNGHYUN JAE |
| Practice Address |
1905 W Springfield Ave Champaign IL 61821 |
| Mailing Address |
2050 E Algonquin Rd Schaumburg IL 60173-4144 |
| Practice Telephone | 8889884066 |
| Practice Fax Number | 8474964850 |
| Mailing Telephone | 8889884066 |
| Mailing Fax Number | 8474964850 |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2015-07-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 019030252 | IL | Dental Providers |
| Street Address |
1905 W SPRINGFIELD AVE |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952912941 | Azin Sadighnia | Dentist | 1905 W Springfield Ave, Champaign, IL 61821-3007 | 2020-08-12 |
| 1023648664 | Jae Ung Jung | Dentist | 1905 W Springfield Ave, Champaign, IL 61821-3007 | 2020-01-23 |
| 1659847002 | Dhruv Dang | Dentist | 1905 W Springfield Ave, Champaign, IL 61821-3007 | 2018-10-23 |
| 1851815369 | Seayoon An | Dentist | 1905 W Springfield Ave, Champaign, IL 61821-3007 | 2017-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326532888 | Cunningham Children's Home of Urbana Il | Residential Treatment Facility, Emotionally Disturbed Children | 1303 N. Cunningham Avenue, Urbana, IL 61821 | 2018-06-19 |
| 1457698169 | Mohamad Ata | Registered Nurse | 1802 S. Mattis, Champaign, IL 61821 | 2013-01-15 |
| 1609124338 | Lolitia Rosanna Newman | Social Worker | 1508 Powers Ln., Champaign, IL 61821 | 2012-08-28 |
| 1679850887 | Kirk Donald Gohsman | Counselor | 106 S. Country Fair Drive, Suite C, Champaign, IL 61821 | 2011-11-16 |
| 1598054777 | Delbert William Nelson Jr. | Psychiatry & Neurology | 2115 Galen Dr, Champaign, IL 61821 | 2011-03-28 |
| 1790946929 | Rdi Vein LLC | Clinic/Center | 2502 Galen Drive, Suite 101, Champaign, IL 61821 | 2008-06-20 |
| 1366620064 | Advanced Aesthetics Surgery & Laser Center, P.C. | Clinic/Center | 2111 West Park Ct., Champaign, IL 61821 | 2008-02-05 |
| 1033398482 | Huey's Home Medical, Inc | Durable Medical Equipment & Medical Supplies | 1207 S Mattis Ave Ste 1, Champaign, IL 61821 | 2007-11-01 |
| 1265630537 | Elizabeth Catherine Tingley | Psychologist | Department of Psychiatry and Psychology-carle Physician, 1802 S. Mattis, Champaign, IL 61821 | 2007-07-06 |
| 1306062922 | Elizabeth Wagner | Counselor | 105 N Fair St, Champaign, IL 61821 | 2007-04-18 |
| Find all providers in zip 61821 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669994232 | George Khazoum | Dentist | 1905 Convenience Pl Ste A, Champaign, IL 61820-8927 | 2017-07-14 |
| 1700034089 | Leonor Cecilia Villalta | Dentist | 2547 W Springfield Ave Apt 2, Champaign, IL 61821-2821 | 2008-08-28 |
| 1619133105 | Jeffrey D Colin | Dentist | 703 S Neil St Ste B, Champaign, IL 61820-5236 | 2008-08-04 |
| 1801051552 | David Wesley Bacheller | Dentist | 305 W Clark St, Champaign, IL 61820-4638 | 2008-07-22 |
| 1992971477 | Lindsey A Hans | Dentist | 2918 Crossing Ct Ste A, Champaign, IL 61822-6100 | 2008-05-05 |
| 1114056272 | Erika Ynga | Dentist | 703 S Neil St, Champaign, IL 61820-5223 | 2007-03-05 |
| 1851420475 | Jim W Yu | Dentist | 1905 Convenience Pl, Suite A, Champaign, IL 61820-8926 | 2007-03-02 |
| 1194866699 | Bruce Gail Sammons | Dentist | 3003 Village Office Place, Champaign, IL 61822-7674 | 2007-02-09 |
| 1316001654 | James Robert Fleming | Dentist | 2004 Fox Dr, Suite F, Champaign, IL 61820-7336 | 2006-12-21 |
| 1659430031 | Nusrat A Hawa | Dentist | 4906 Peifer Ln, Champaign, IL 61822-8321 | 2006-12-08 |
| Find all providers in CHAMPAIGN | ||||
Please comment or provide details below to improve the information on SEUNGHYUN JAE.
| 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.