Individual provider Active NPI

Yangsook Han, DDS

  • General Practice Dentistry
  • Bronx, NY
National Provider Identifier
1043418346
Registry record updated Apr 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
053181 Issued in NY
Practice address
930 E Tremont Ave
Bronx, NY 10460-4363
Phone
(718) 764-1633
Fax
(646) 224-1320
NPI assigned
Jul 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 053181 NY Primary

Addresses

Primary practice location

930 E Tremont Ave
Bronx, NY 10460-4363

Mailing address

930 E Tremont Ave
Bronx, NY 10460-4363
Phone (718) 764-1633

Other identifiers 1

IdentifierTypeStateIssuer
053181OtherNYLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20100628000195 NY Practitioner - Oral Surgery 6901937481 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Uptown Healthcare Management, Inc. CurrentSince Aug 11, 2018 Accepting new patients

Locations

930 E Tremont Ave
Fl 3
Bronx, NY 10460
Phone (718) 620-6068

930 E Tremont Ave
Bronx, NY 10460
Phone (718) 764-1660

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1183766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366761600000",
    "number": "1043418346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 E TREMONT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104604363",
            "telephone_number": "718-764-1633",
            "fax_number": "646-224-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 E TREMONT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104604363",
            "telephone_number": "718-764-1633",
            "fax_number": "646-224-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "YANGSOOK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-07",
        "last_updated": "2013-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "053181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "053181",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.