Ming Hong Pun, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30-021446 Issued in OH

Practice address

1199 Delaware Ave
Suite 106
Marion, OH 43302-6475

Phone

(740) 387-1324

NPI assigned

Jan 4, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
• devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9
• devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
• KY PPO C-SNP

Interoperability endpoints

• Direct secure messaging: minghongjim.pun.p1@direct.centerstreetclinic.nextgenshare.com

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.

• Appleseed Family Dental LLC

  • General Practice Dentistry
  • Powell, OH
  • NPI 1902047798
  NPD Authorized official
• Center Street Community Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Marion, OH
  • NPI 1780984211
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1013064062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6786 BARONET BLVD",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430171271",
            "telephone_number": "740-244-5025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 DELAWARE AVE",
            "address_2": "SUITE 106",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026475",
            "telephone_number": "740-387-1324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUN",
        "first_name": "MING",
        "middle_name": "HONG",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-021446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2286637",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Progressive Eye Care, LLC
• Progressive Living, Inc
• Sara Provenzale
• Joel D Provenzano, M.D.
• Mario William Puleo II, MD
• Tarlok S Purewal, M D
• Jackie Lee Quach, M.D.
• Kai Quin, M.D.
• Corri R. Rabun, RPH
• Bhola Nath Rama, MD

• General Practice Dentistry in Marion, OH
• Providers in Marion, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.