Woodstock Dental Associates, LTD.

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

019025426 Issued in IL

Legal business name

WOODSTOCK DENTAL ASSOCIATES, LTD.

Practice address

666 W Jackson St Ste B
Woodstock, IL 60098-3198

Phone

(815) 338-1138

Fax

(815) 338-3910

NPI assigned

Jan 30, 2014

Last updated

Jan 30, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Chungyoon Ha, DDS

Title

Associate

Phone

(815) 338-1138

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1391040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391040000000",
    "number": "1144643966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "666 W JACKSON ST STE B",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600983198",
            "telephone_number": "815-338-1138",
            "fax_number": "815-338-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "666 W JACKSON ST STE B",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600983198",
            "telephone_number": "815-338-1138",
            "fax_number": "815-338-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODSTOCK DENTAL ASSOCIATES, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-30",
        "last_updated": "2014-01-30",
        "status": "A",
        "authorized_official_last_name": "HA",
        "authorized_official_first_name": "CHUNGYOON",
        "authorized_official_title_or_position": "ASSOCIATE",
        "authorized_official_telephone_number": "815-338-1138",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "IL",
            "license": "019025426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Wolf
• Maria Wondra, D.P.T.
• James L Woodman, MD
• Woodstock Chiropractic Center
• Woodstock Christian Life Services (Hearthstone Manor)
• Woodstock Fire/Rescue District
• Woodstock Imaging Associates, Inc.
• Woodstock Medical & Surgical Center, LTD
• Woodstock Nursing and Rehab Center LLC (La Bella of Woodstock)
• Woodstock School District

• Exclusive Provider Organization in Woodstock, IL
• Providers in Woodstock, IL by specialty
• Exclusive Provider Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; 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.