Active NPI
Youngjoo Cha, D.M.D.
- General Practice Dentistry
- Lexington, MA
National Provider Identifier
1407979370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 21521
- Practice address
- 57 Bedford St
Lexington, MA 02420-4500 - Phone
- (781) 861-8978
- NPI assigned
- Apr 7, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 21521 | MA | Primary |
Addresses
Primary practice location
57 Bedford St
Lexington, MA 02420-4500
Mailing address
55 Curtis St
Reading, MA 01867-3904
Phone (781) 942-0901
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- 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 |
|---|---|---|---|---|
| I20160609001907 | MA | Order and Referring Only - Other (Physician) | 3870883424 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21521 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407979370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 CURTIS ST",
"city": "READING",
"state": "MA",
"postal_code": "018673904",
"telephone_number": "781-942-0901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57 BEDFORD ST",
"city": "LEXINGTON",
"state": "MA",
"postal_code": "024204500",
"telephone_number": "781-861-8978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHA",
"first_name": "YOUNGJOO",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "21521",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.