Active NPI
Byung Joo Nahm, D.D.S.
- General Practice Dentistry
- Mineola, NY
National Provider Identifier
1386007862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 63730
- Practice address
- 200 Old Country Rd Ste 460
Mineola, NY 11501-4293 - Phone
- (516) 663-2752
- Fax
- (516) 663-9373
- NPI assigned
- Apr 1, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 63730 | CA | Primary |
Addresses
Primary practice location
200 Old Country Rd Ste 460
Mineola, NY 11501-4293
Mailing address
31 Beach St Apt 805
Boston, MA 02111-1603
Phone (607) 351-5786
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 |
|---|---|---|---|
| 63730 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459468800000",
"number": "1386007862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 BEACH ST APT 805",
"city": "BOSTON",
"state": "MA",
"postal_code": "021111603",
"telephone_number": "607-351-5786",
"fax_number": "516-663-2039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 OLD COUNTRY RD STE 460",
"city": "MINEOLA",
"state": "NY",
"postal_code": "115014293",
"telephone_number": "516-663-2752",
"fax_number": "516-663-9373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAHM",
"first_name": "BYUNG JOO",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-04-01",
"last_updated": "2016-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "63730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mineola, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.