Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1295221455 Individual Practitioner Male Practitioner

Dr. Jun Kyung Ko , DMD, ABGD

Dentist - General Practice • Edwards Afb, CA

Professional Overview & Biography Verified Profile Summary

Dr. Jun Kyung Ko, DMD, ABGD is a registered healthcare professional specializing in Dentist - General Practice in Edwards Afb, CA. Practice services are available at 412 MDG 30 NIGHTINGALE ROAD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

412 Mdg 30 Nightingale Road

Edwards Afb, CA 935245071

Telephone 6612772872
Associated Practice Facility / Clinic
🏢 Usaf 95mdos Facility NPI 1467413773

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Edwards Afb, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
1 Specialists

Practicing in Edwards Afb, CA (18734 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-07-25
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License AZ D010087

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
NPI 1144613670

Doctor of Dental Medicine

Dr. Phillip Lopiccolo , DDS

Dentist - Periodontics

NPI 1366465890

Doctor of Dental Surgery

NPI 1538585872
Mary Timothy , RDH

Dental Hygienist

NPI 1861562738

Registered Dental Hygienist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events
📍
Updated Practice Location July 25, 2024

Registered at 412 MDG 30 NIGHTINGALE ROAD, EDWARDS AFB, CA 935245071 (Tel: 6612772872)

📍
Updated Business Mailing Address July 25, 2024

Registered at 412 MDG 30 NIGHTINGALE ROAD, EDWARDS AFB, CA 935240001

👤
Provider Name / Credentials Updated July 25, 2024

Recorded as JUN KYUNG KO, DMD, ABGD

📍
Updated Practice Location September 13, 2023

Registered at UNIT 5071 BOX MEDICAL, APO, AP 963285071 (Tel: 3152258864)

📍
Updated Practice Location May 31, 2019

Registered at 59 DG-AF POSTGRADUATE DENTAL SCHOOL, 2133 PEPPERRELL STREET, BUILDING 3352, JBSA-LACKLAND, TX 782365313 (Tel: 2102926258)

📍
Updated Business Mailing Address May 31, 2019

Registered at 59 DG-AF POSTGRADUATE DENTAL SCHOOL, 2133 PEPPERRELL STREET, BUILDING 3352, JBSA-LACKLAND, TX 782365313

👤
Provider Name / Credentials Updated May 31, 2019

Recorded as JUN KYUNG KO, DMD

NPI Profile Active July 25, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location July 25, 2018

Registered at 1100 WILFORD HALL LOOP, BLDG 4554, JBSA LACKLAND, TX 78236 (Tel: 2102926225)

📍
Updated Business Mailing Address July 25, 2018

Registered at 503 AVENUE A APT 1444, SAN ANTONIO, TX 782151278 (Tel: 6238894302)

👤
Provider Name / Credentials Updated July 25, 2018

Recorded as JUN KYUNG KO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 25, 2018

Dentist (License #D010087 in AZ)

🟢
Initial NPI Registration & Enumeration July 10, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1295221455
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 10, 2018
Last Update: July 25, 2024
Sole Proprietor: No

Mailing Address

412 Mdg 30 Nightingale Road

Edwards Afb, CA 935240001

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.