NPIMap

Organization Active NPI

CS Dental LLC

  • General Practice Dentistry
  • Bloomington, IN
National Provider Identifier
1225330582
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12011208A Issued in IN
Legal business name
CS DENTAL LLC
Practice address
330 N Jacob Dr
Bloomington, IN 47404-4823
Phone
(812) 323-7400
Fax
(812) 323-7595
NPI assigned
Nov 18, 2010
Last updated
Nov 18, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2010

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

Authorized official

Name
Dr. Kijin Woo, DMDNPI 1396901005
Title
Owner
Phone
(866) 273-8204

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 12011208A IN Primary

Addresses

Primary practice location

330 N Jacob Dr
Bloomington, IN 47404-4823

Mailing address

PO Box 3189
Syracuse, NY 13220-3189
Phone (866) 273-8204

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1290038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290038400000",
    "number": "1225330582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189",
            "telephone_number": "866-273-8204",
            "fax_number": "866-803-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N JACOB DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474044823",
            "telephone_number": "812-323-7400",
            "fax_number": "812-323-7595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CS DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-18",
        "last_updated": "2010-11-18",
        "status": "A",
        "authorized_official_last_name": "WOO",
        "authorized_official_first_name": "KIJIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "866-273-8204",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011208A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2010; 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.