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Deactivated NPI 1871089987 Deactivated / Inactive NPI Male Practitioner

Dr. Jae-Woo Jung , DDS

Dentist - General Practice • Reston, VA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jae-Woo Jung has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 02, 2018
NPI Deactivation Date October 13, 2023
Total Practice Duration ~5 Years of Practice (2018 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Jae-Woo Jung, DDS was a registered Dentist - General Practice practicing in Reston, VA. Throughout an active medical career spanning 5 years, Dr. Jung provided care at the practice location at 11864 SUNRISE VALLEY DR STE 100 until profile deactivation on 2023-10-13.

Practice Location & Contact Primary Location

Practice Address

11864 Sunrise Valley Dr Ste 100

Reston, VA 201913311

Telephone 7039641777
Fax 7039641776
Associated Practice Facility / Clinic
🏢 Pure Dental Llc Facility NPI 1487436556

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Reston, VA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.6 Yrs
Regional Practice Density
44 Specialists

Practicing in Reston, VA (3535 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: 2024-09-30
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License VA 0401416137

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.

Career & Practice History Timeline

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

9 Historical Events
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Updated Practice Location September 30, 2024

Registered at 11864 SUNRISE VALLEY DR STE 100, RESTON, VA 201913311 (Tel: 7039641777)

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NPI Profile Reactivated October 20, 2023

Record officially reactivated for active practice on October 20, 2023

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NPI Profile Deactivated October 13, 2023

Record deactivated on October 13, 2023

NPI Profile Active July 02, 2018

NPI status registered as active in NPPES database

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Updated Practice Location July 02, 2018

Registered at 8140 STONEWALL SHOPS SQ, GAINESVILLE, VA 201553891 (Tel: 5712988279)

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Updated Business Mailing Address July 02, 2018

Registered at 7322 PINEWOOD ST, FALLS CHURCH, VA 220462726

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Provider Name / Credentials Updated July 02, 2018

Recorded as JAE-WOO JUNG, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 02, 2018

Dentist (License #0401416137 in VA)

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Initial NPI Registration & Enumeration July 02, 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: 1871089987
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 02, 2018
Last Update: September 30, 2024
Deactivation Date: October 13, 2023
Sole Proprietor: Yes

Mailing Address

7322 Pinewood St

Falls Church, VA 220462726

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.