Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1194501031 Individual Practitioner Female Practitioner

Jungsoo Nam

Dentist • Bloomington, IN

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Jungsoo Nam is a registered healthcare professional specializing in Dentist in Bloomington, IN. Official NPI practice address is registered at 330 N JACOB DR.

Practice Location & Contact Primary Location

Practice Address

330 N Jacob Dr

Bloomington, IN 474044823

Telephone 8123237595
Associated Practice Facility / Clinic
🏢 Cs Dental Llc Facility NPI 1225330582

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Bloomington, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 7.1 Yrs
Regional Practice Density
35 Specialists

Practicing in Bloomington, IN (1682 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: 2025-05-29
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License IN 12014730A

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.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Secondary Practice Locations

1001 Shadow Ln

Las Vegas, NV 891064124

Phone: 7027865928

Practice Associates & Co-Workers

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

3 Associated Practitioners
NPI 1538912001

Doctor of Dental Surgery

Hyunji Lee

Dentist - General Practice

NPI 1588212310
NPI 1952297210

Doctor of Dental Surgery

Career & Practice History Timeline

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

7 Historical Events
📍
Updated Practice Location May 29, 2025

Registered at 330 N JACOB DR, BLOOMINGTON, IN 474044823 (Tel: 8123237595)

NPI Profile Active September 06, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location September 06, 2023

Registered at 1001 SHADOW LN, LAS VEGAS, NV 891064124 (Tel: 7027865928)

📍
Updated Business Mailing Address September 06, 2023

Registered at 1001 SHADOW LN, LAS VEGAS, NV 891064124

👤
Provider Name / Credentials Updated September 06, 2023

Recorded as JUNGSOO NAM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 06, 2023

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration September 06, 2023

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: 1194501031
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 06, 2023
Last Update: May 29, 2025
Sole Proprietor: No

Mailing Address

1001 Shadow Ln

Las Vegas, NV 891064124

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.