Individual provider Active NPI

Christine Marie O'Hea, DMD MDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • New York, NY
National Provider Identifier
1417233750
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
057228 Issued in NY
Practice address
100 Haven Ave
New York, NY 10032-2645
Phone
(212) 342-0107
NPI assigned
Nov 1, 2011
Last updated
Jan 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DI02071000 NJ
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 057228 NY Primary

Addresses

Primary practice location

100 Haven Ave
New York, NY 10032-2645

Mailing address

5 Craig LN
Chester, NJ 07930-2228
Phone (973) 573-0004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160728002591 NY Order and Referring Only - DentistPractitioner - Dentist 8527351444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI02071000NJMDOrthodontics and Dentofacial Orthopedic Dentist
057228NYMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1417233750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 CRAIG LN",
            "city": "CHESTER",
            "state": "NJ",
            "postal_code": "079302228",
            "telephone_number": "973-573-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HAVEN AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100322645",
            "telephone_number": "212-342-0107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'HEA",
        "first_name": "CHRISTINE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DMD MDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-01",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "DI02071000",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "057228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.