Active NPI
NA Young Ahn, D.D.S
- Dentist
- San Jose, CA
National Provider Identifier
1104944172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 54603
- Practice address
- 1984 Foxworthy Ave
San Jose, CA 95124-1509 - Phone
- (408) 377-2225
- Fax
- (408) 377-2226
- NPI assigned
- Mar 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 54603 | CA | Primary |
Addresses
Primary practice location
1984 Foxworthy Ave
San Jose, CA 95124-1509
Mailing address
1984 Foxworthy Ave
San Jose, CA 95124-1509
Phone (408) 377-2225
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D54603 | Other | CA | DENTICAL PROVIDER NUMBER |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362787200000",
"number": "1104944172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1984 FOXWORTHY AVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951241509",
"telephone_number": "408-377-2225",
"fax_number": "408-377-2226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1984 FOXWORTHY AVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951241509",
"telephone_number": "408-377-2225",
"fax_number": "408-377-2226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHN",
"first_name": "NA YOUNG",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-27",
"last_updated": "2013-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "54603",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTICAL PROVIDER NUMBER",
"identifier": "D54603",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.