TH Dental Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02569100 Issued in NJ

Legal business name

TH DENTAL INC.

Doing business as

PrimeCare Dental

Practice address

4 Hunter St
Suite 2B
Lodi, NJ 07644-1608

Phone

(201) 403-8230

NPI assigned

Apr 7, 2016

Organization subpart

No

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

Authorized official

Name

Taehyung Moon, DDS

Title

President

Phone

(973) 955-4928

Specialties & licenses 1

Addresses

Other names 1

• PrimeCare Dental Doing business as

Locations

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479340800000",
    "number": "1265896070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HUNTER ST",
            "address_2": "SUITE 2B",
            "city": "LODI",
            "state": "NJ",
            "postal_code": "076441608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 HUNTER ST",
            "address_2": "SUITE 2B",
            "city": "LODI",
            "state": "NJ",
            "postal_code": "076441608",
            "telephone_number": "201-403-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TH DENTAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-07",
        "last_updated": "2016-11-17",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "TAEHYUNG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-955-4928",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02569100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PrimeCare Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Lodi, NJ
• Providers in Lodi, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; 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.