Justina Jean Ahn, DMD
Individual provider Active NPI Dentist · Fort Bragg, NC
NPI 1003645904 · NPPES record last updated Sep 6, 2025
Key facts
- NPI
- 1003645904
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 14035483-9926 (UT)
- Practice address
- 2817 Rock Merritt Ave
Fort Bragg, NC 28310-4613 - Phone
- (910) 907-8922
- Fax
- (910) 907-6069
- NPI assigned
- Jul 29, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14035483-8903 | UT | MD | Dentist |
| 14035483-9926 | UT | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 14035483-9926 | UT | Yes |
| Dentist | 122300000X | 14035483-8903 | UT |
Addresses
Primary practice location
2817 Rock Merritt Ave
Fort Bragg, NC 28310-4613
Mailing address
2817 Rock Merritt Ave
Fort Bragg, NC 28310-0001
Other providers in Fort Bragg, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.