Active NPI
Joon-Yong Koh
- General Practice Dentistry
- Lake Katrine, NY
National Provider Identifier
1447590773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 059553-1
- Practice address
- 1733 Ulster Ave
Lake Katrine, NY 12449-5426 - Phone
- (412) 818-4975
- NPI assigned
- Feb 23, 2013
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 059553-1 | NY | Primary |
Addresses
Primary practice location
1733 Ulster Ave
Lake Katrine, NY 12449-5426
Mailing address
1733 Ulster Ave
Lake Katrine, NY 12449-5426
Phone (845) 512-1230
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 |
|---|---|---|---|---|
| I20160310000947 | NJ | Order and Referring Only - Dentist | 1456657816 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 059553-1 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522886400000",
"number": "1447590773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1733 ULSTER AVE",
"city": "LAKE KATRINE",
"state": "NY",
"postal_code": "124495426",
"telephone_number": "845-512-1230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1733 ULSTER AVE",
"city": "LAKE KATRINE",
"state": "NY",
"postal_code": "124495426",
"telephone_number": "412-818-4975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOH",
"first_name": "JOON-YONG",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-02-23",
"last_updated": "2018-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "059553-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Katrine, NY
- Kingston NH Operation LLC (Ten Broeck Center for Rehabilitation & Nursing)
- Kenneth T Kircher, DO
- Jean M Kirtio, PHYSICAL THER. ASST
- Diana Klebanoff, LCSWR
- Roy A Kline, O.D.
- Diane J. Kraus, MD
- KRNH Inc (Northeast Center For Special Care)
- KRNH, Inc (Northeast Center for Special Care)
- Daniel Lack, O.D.
- Nicole Laurita, OTR/L
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; 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.