Sam Hyun-Ju NA, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

059470 Issued in NY

Practice address

5 HDSN Vly Prof PLZ
Newburgh, NY 12550

Phone

(845) 562-5570

NPI assigned

May 2, 2016

Last updated

Dec 14, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Elite Denal Care P.C.

  • Dentist
  • Elmhurst, NY
  • NPI 1154463016
  NPD (past)

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

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544745600000",
    "number": "1093160608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 COLUMBINE LN",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125535467",
            "telephone_number": "347-552-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 HDSN VLY PROF PLZ",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "12550",
            "telephone_number": "845-562-5570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9438 59th Ave",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "NY",
            "postal_code": "113735151",
            "country_code": "US",
            "telephone_number": "718-699-1100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3127 35th St Apt 3F",
            "address_purpose": "LOCATION",
            "city": "Astoria",
            "state": "NY",
            "postal_code": "11106",
            "country_code": "US",
            "telephone_number": "347-552-1023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "567 W 191st St Apt 34",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100403509",
            "country_code": "US",
            "telephone_number": "347-552-1023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3127 35th St Apt 3F",
            "address_purpose": "LOCATION",
            "city": "Astoria",
            "state": "NY",
            "postal_code": "11106",
            "country_code": "US",
            "telephone_number": "347-552-1023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NA",
        "first_name": "SAM",
        "middle_name": "HYUN-JU",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-02",
        "last_updated": "2018-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "059470",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariellen Murphy, RN
• Nashwa Mustafa Abdo Ali, M.D
• Jane Alison Myer, MSW LCSW
• Courtland Lebrandt Myles
• Sateesh Mypati
• Laith Anton Naayem, L.AC.
• Khadija Naeem
• Aiswarya Nair, MBBS
• Ellis Nam, RN
• Sangmi Nam, L.AC.

• General Practice Dentistry in Newburgh, NY
• Providers in Newburgh, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.

Verify at the official NPI Registry.