Individual provider Active NPI

Yusun Gohard, DDS

  • General Practice Dentistry
  • Madison, NJ
National Provider Identifier
1417053554
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D102255300 Issued in NJ
Practice address
34 Prospect St
Madison, NJ 07940-2640
Phone
(973) 377-2222
Fax
(201) 653-3581
NPI assigned
Sep 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D102255300 NJ Primary

Addresses

Primary practice location

34 Prospect St
Madison, NJ 07940-2640

Mailing address

34 Prospect St
Madison, NJ 07940-2640
Phone (973) 377-2222

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

LicenseStateTypeSpecialty
D102255300NJMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1417053554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 PROSPECT ST",
            "city": "MADISON",
            "state": "NJ",
            "postal_code": "079402640",
            "telephone_number": "973-377-2222",
            "fax_number": "201-653-3581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 PROSPECT ST",
            "city": "MADISON",
            "state": "NJ",
            "postal_code": "079402640",
            "telephone_number": "973-377-2222",
            "fax_number": "201-653-3581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOHARD",
        "first_name": "YUSUN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "D102255300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.