Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1154762599 Individual Practitioner Male Practitioner

Dr. Jun Soetanto , DMD

Dentist • Cleveland, OH

Professional Overview & Biography Verified Profile Summary

Dr. Jun Soetanto, DMD is a registered healthcare professional specializing in Dentist in Cleveland, OH. Practice services are available at 11201 SHAKER BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

11201 Shaker Blvd
Suite 136

Cleveland, OH 441043869

Telephone 2163687238
Associated Practice Facility / Clinic
🏢 Faith Medical Associates, Inc Facility NPI 1376538363

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Cleveland, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 15.8 Yrs
State Avg: 18.4 Yrs
Regional Practice Density
193 Specialists

Practicing in Cleveland, OH (2953 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

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License OH RES 33.79

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.

Practice Associates & Co-Workers

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

25 Associated Practitioners
Javier Rodriguez Del Rey

Dentist - General Practice

NPI 1003430372
Ariel Delgado

Dentist - General Practice

NPI 1003431818
NPI 1124340062

Doctor of Dental Medicine

Dr. Mia Zuber , DDS

Dentist - General Practice

NPI 1164933982

Doctor of Dental Surgery

Mahmoud Aboulfarag

Dentist - General Practice

NPI 1174251425
NPI 1215422001

Doctor of Dental Medicine

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active July 15, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location July 15, 2013

Registered at 11201 SHAKER BLVD, SUITE 136, CLEVELAND, OH 441043869 (Tel: 2163687238)

📍
Updated Business Mailing Address July 15, 2013

Registered at 11201 SHAKER BLVD, SUITE 136, CLEVELAND, OH 441043869 (Tel: 2163687238)

👤
Provider Name / Credentials Updated July 15, 2013

Recorded as JUN SOETANTO, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 15, 2013

Dentist (License #RES 33.79 in OH)

🟢
Initial NPI Registration & Enumeration July 15, 2013

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Jun Soetanto. Be the first to share your experience!

Sign in to leave a review for Dr. Jun Soetanto

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1154762599
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 15, 2013
Last Update: July 15, 2013
Sole Proprietor: No

Mailing Address

11201 Shaker Blvd, Suite 136

Cleveland, OH 441043869

Phone: 2163687238

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.