NPIMap

Organization Active NPI

Hollywood Dentistry L.L.C

  • General Practice Dentistry
  • Newark, NJ
National Provider Identifier
1124370374
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02140100 Issued in NJ
Legal business name
HOLLYWOOD DENTISTRY L.L.C
Practice address
23 Branford Place
Newark, NJ 07102
Phone
(973) 424-0040
Fax
(973) 424-0089
NPI assigned
Oct 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Authorized official

Name
Dr. John Young Keh, DDS
Title
General Dentist
Phone
(973) 424-0040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 22DI02140100 NJ Primary

Addresses

Primary practice location

23 Branford Place
Newark, NJ 07102

Mailing address

23 Branford Place
Newark, NJ 07102
Phone (973) 424-0040

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350000000000",
    "number": "1124370374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 BRANFORD PLACE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07102",
            "telephone_number": "973-424-0040",
            "fax_number": "973-424-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 BRANFORD PLACE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07102",
            "telephone_number": "973-424-0040",
            "fax_number": "973-424-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLYWOOD DENTISTRY L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-12",
        "last_updated": "2012-10-12",
        "status": "A",
        "authorized_official_last_name": "KEH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "YOUNG",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "973-424-0040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02140100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; 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.