Provider Type Icon

DR. PETER SUCHOL JANG D.D.S. NPI 1912967431


NPI Information

NPI: 1912967431
Provider Name: DR. PETER SUCHOL JANG, D.D.S.
Classification: Dentist - 1223X0400X
Entity Type: Individual

Specialization: Orthodontics and Dentofacial Orthopedics

Address:
3161 HIGHWAY 64
SUITE 400
EADS, TN
ZIP 38028
Phone: (901) 813-8476
Get Directions

DR. Peter Suchol Jang, D.D.S. is an orthodontics and dentofacial orthopedics dentist in Eads, TN. The provider is that area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. DR. Peter Suchol Jang, D.D.S. NPI is 1912967431. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3161 HIGHWAY 64
SUITE 400
EADS, TN
ZIP 38028-021
Phone: (901) 813-8476
Fax: (901) 813-8479

The enumeration date for this NPI number is 3/27/2006 and was last updated on 5/11/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1122300000XDentistDS 8164TENNESSEENo
21223X0400XDentistOrthodontics and Dentofacial Orthopedics3601ARKANSASNo
31223X0400XDentistOrthodontics and Dentofacial OrthopedicsDS 8164TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15440084MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.