Active NPI
Leah Sooyeon Nam, DMD
- Student in an Organized Health Care Education/Training Program
- Newark, NJ
National Provider Identifier
1003305160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 110 Bergen St
Newark, NJ 07103-2495 - Phone
- (973) 972-9592
- NPI assigned
- May 4, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
110 Bergen St
Newark, NJ 07103-2495
Mailing address
333 1St St Apt a
Palisades Park, NJ 07650-2676
Phone (201) 705-3203
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kim & Nam LLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Carlstadt, NJ
- NPI 1356057806
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525392000000",
"number": "1003305160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 1ST ST APT A",
"city": "PALISADES PARK",
"state": "NJ",
"postal_code": "076502676",
"telephone_number": "201-705-3203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 BERGEN ST",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071032495",
"telephone_number": "973-972-9592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAM",
"first_name": "LEAH",
"middle_name": "SOOYEON",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-04",
"last_updated": "2018-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.