Individual provider Active NPI

Min Roh, DDS

  • General Practice Dentistry
  • Norwalk, CA
National Provider Identifier
1447304852
Registry record updated Dec 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
48365 Issued in CA
Practice address
11550 Rosecrans Ave Ste 101
Norwalk, CA 90650-3881
Phone
(625) 474-1100
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2018

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 48365 CA Primary

Addresses

Primary practice location

11550 Rosecrans Ave Ste 101
Norwalk, CA 90650-3881

Mailing address

11550 Rosecrans Ave Ste 101
Norwalk, CA 90650-3881
Phone (625) 474-1100

Other practice location 1

1111 E Tulare Ave
Tulare, CA 93274-4561
Phone (559) 688-3314

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
48365CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1447304852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11550 ROSECRANS AVE STE 101",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906503881",
            "telephone_number": "625-474-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11550 ROSECRANS AVE STE 101",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906503881",
            "telephone_number": "625-474-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 E Tulare Ave",
            "address_purpose": "LOCATION",
            "city": "Tulare",
            "state": "CA",
            "postal_code": "932744561",
            "country_code": "US",
            "telephone_number": "559-688-3314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROH",
        "first_name": "MIN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2018; 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.