| NPI | 1053478115 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2007-01-01 |
| Last Updated | 2007-07-08 |
| Mailing Address | 3715 Washington Rd Kenosha, WI 53144-1629 United States Phone: (262) 654-6800 | Fax: (262) 657-9995 📍 View Map |
| Primary Practice Address | 3715 Washington Rd Kenosha, WI 53144-1629 United States Phone: (262) 654-6800 | Fax: (262) 657-9995 📍 View Map |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 1223G0001X – Dentist, General Practice | WI | 1687 |
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About NPI 1053478115
Edmund Jung is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1053478115. The primary specialty listed is Dentist, General Practice. The provider is located in Kenosha, WI. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2007-01-01. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1053478115?
NPI 1053478115 belongs to Edmund Jung, a Dentist, General Practice in Kenosha, WI. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1053478115 active?
The current status of NPI 1053478115 in the NPPES registry is Active. The record was last updated on 2007-07-08.
What specialty is NPI 1053478115?
NPI 1053478115 is classified under the taxonomy Dentist, General Practice. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1053478115?
You can verify NPI 1053478115 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1053478115?
The primary practice address on file for NPI 1053478115 is 3715 Washington Rd, Kenosha, WI 53144-1629. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1053478115 issued?
NPI 1053478115 was first issued (enumerated) on 2007-01-01. The NPPES record was last updated on 2007-07-08.
Practice Location Map
Edmund Jung is located at 3715 Washington Rd, Kenosha, WI. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Edmund Jung. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1053478115. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Dentist, General Practice | 1687 | WI |