Active NPI
Simon S Oh, D.D.S.
- Dentist
- Philadelphia, PA
National Provider Identifier
1386997641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS039365
- Practice address
- 207 N Broad St
1St Floor
Philadelphia, PA 19107-1500 - Phone
- (215) 561-0562
- NPI assigned
- Oct 23, 2012
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DS039365 | PA | Primary |
Addresses
Primary practice location
207 N Broad St
1St Floor
Philadelphia, PA 19107-1500
Mailing address
817 N Easton Rd
Doylestown, PA 18902-1024
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170615000218 | NJ | Order and Referring Only - Dentist | 2961770920 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS039365 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496188800000",
"number": "1386997641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "817 N EASTON RD",
"city": "DOYLESTOWN",
"state": "PA",
"postal_code": "189021024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 N BROAD ST",
"address_2": "1ST FLOOR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191071500",
"telephone_number": "215-561-0562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OH",
"first_name": "SIMON",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-23",
"last_updated": "2017-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS039365",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.