Peter H. Bae D.D.S Dental Corp.

Primary specialty

DentistTaxonomy code 122300000X

License

50034 Issued in CA

Legal business name

PETER H. BAE D.D.S DENTAL CORP.

Doing business as

Dental Playground

Practice address

3651 Crenshaw Blvd
Los Angeles, CA 90016-4849

Phone

(323) 291-3900

Fax

(323) 846-1158

NPI assigned

Jun 29, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Peter Hyun Bae, D.D. S

Title

Owner/ Dentist

Phone

(323) 291-3900

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dental Playground Doing business as

Locations

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246233600000",
    "number": "1164650164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3651 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900164849",
            "telephone_number": "323-291-3900",
            "fax_number": "323-846-1158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900164849",
            "telephone_number": "323-291-3900",
            "fax_number": "323-846-1158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER H. BAE D.D.S DENTAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-29",
        "last_updated": "2009-06-29",
        "status": "A",
        "authorized_official_last_name": "BAE",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "HYUN",
        "authorized_official_title_or_position": "OWNER/ DENTIST",
        "authorized_official_telephone_number": "323-291-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D. S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "50034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "810623008",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Playground",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Peter J. Chung, M.D. Inc.

• Dentist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; 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.