Caroline Kim Ahn, DMD
Individual provider Active NPI Endodontics · Ridgefield, NJ
NPI 1295997161 · NPPES record last updated Jul 22, 2014
Key facts
- NPI
- 1295997161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Endodontics 1223E0200X
- License
- 22DI02463700 (NJ)
- Practice address
- 560 Bergen Blvd
Ridgefield, NJ 07657-2024 - Phone
- (201) 945-4477
- NPI assigned
- Jul 1, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 15, 2015 through Dec 15, 2027
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 055836 | NY | MD | Clinical Social Worker |
| 22DI02463700 | NJ | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luisa Milo DDS LLC | Past | Accepting new patients | |
| Park Dental Associates, Inc | Past | Accepting new patients | |
| Park Dental Arts, LLC | Past | Accepting new patients | |
| Allendale Dental PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 055836 | NY | |
| Endodontics | 1223E0200X | 22DI02463700 | NJ | Yes |
Addresses
Primary practice location
560 Bergen Blvd
Ridgefield, NJ 07657-2024
Mailing address
355 Sylvan Ave
Leonia, NJ 07605-2026
Other providers in Ridgefield, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.