Jaeho Chae

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

011104 Issued in CT

Practice address

483 Middle Tpke W
Manchester, CT 06040-3863

Phone

(860) 645-0111

NPI assigned

Jan 28, 2014

Last updated

Mar 31, 2016By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

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

{
    "created_epoch": "1390867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1124441167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 7TH ST APT A",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076502271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 MIDDLE TPKE W",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060403863",
            "telephone_number": "860-645-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAE",
        "first_name": "JAEHO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-28",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "011104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Alan Cavanna, PAC
• George Salvatore Caye, D.D.S.
• Barbara J Cecere
• Central Physical Therapy Inc
• Gary Cesca, LCSW
• Paula Lucine Chakerian, MD
• Yamini Chalikonda
• Chakeya Chapman
• Charlies Airport Transport LLC
• Charter Oak Family Center LLC

• General Practice Dentistry in Manchester, CT
• Providers in Manchester, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; 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.