Individual provider Active NPI

Jun Oh, DDS

  • General Practice Dentistry
  • Carrollton, TX
National Provider Identifier
1184905689
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
27389 Issued in TX
Practice address
2138 N Josey LN Ste 104
Carrollton, TX 75006-3037
Phone
(972) 242-4505
NPI assigned
Aug 29, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 27389 TX Primary
General Practice Dentistry 1223G0001X 2901020497 MI

Addresses

Primary practice location

2138 N Josey LN Ste 104
Carrollton, TX 75006-3037

Mailing address

2138 N Josey LN Ste 104
Carrollton, TX 75006-3037
Phone (972) 242-4505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20160601001466 TX Order and Referring Only - DentistPractitioner - Dentist 9830489996

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901020497MIMDGeneral Practice Dentistry
27389TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Brident Dental Associates PC Past Accepting new patients
South Texas Dental Associates, L.P. Past Accepting new patients
J&J Dental Group General Practice PastSince Jan 31, 2021 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1314576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1184905689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2138 N JOSEY LN STE 104",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750063037",
            "telephone_number": "972-242-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2138 N JOSEY LN STE 104",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750063037",
            "telephone_number": "972-242-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OH",
        "first_name": "JUN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-29",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27389",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020497",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

Verify at the official NPI Registry.