Active NPI
Nam Jun Cho
- Periodontics
- Fort Lee, NJ
National Provider Identifier
1316436702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 22DI02939800
- Practice address
- 800 Park Ave Apt 812
Fort Lee, NJ 07024-3771 - Phone
- (917) 520-2623
- NPI assigned
- May 1, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 22DI02939800 | NJ | Primary |
Addresses
Primary practice location
800 Park Ave Apt 812
Fort Lee, NJ 07024-3771
Mailing address
800 Park Ave Apt 812
Fort Lee, NJ 07024-3771
Phone (917) 520-2623
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02939800 | NJ | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682899200000",
"number": "1316436702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 PARK AVE APT 812",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "070243771",
"telephone_number": "917-520-2623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 PARK AVE APT 812",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "070243771",
"telephone_number": "917-520-2623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHO",
"first_name": "NAM JUN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-01",
"last_updated": "2023-05-01",
"certification_date": "2023-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NJ",
"license": "22DI02939800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lee, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.