Doe Myung NA, D.D.S. a Dental Corp

Primary specialty

DentistTaxonomy code 122300000X

License

29391 Issued in CA

Legal business name

DOE MYUNG NA, D.D.S. A DENTAL CORP

Practice address

7604 Reseda Blvd
Reseda, CA 91335-2822

Phone

(818) 343-3916

Fax

(818) 343-9640

NPI assigned

Jun 16, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Doe Myung NA, D.D.S.

Title

Ceo

Phone

(818) 343-3916

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245110400000",
    "number": "1528295672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7604 RESEDA BLVD",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913352822",
            "telephone_number": "818-343-3916",
            "fax_number": "818-343-9640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7604 RESEDA BLVD",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913352822",
            "telephone_number": "818-343-3916",
            "fax_number": "818-343-9640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOE MYUNG NA, D.D.S. A DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-16",
        "last_updated": "2009-06-16",
        "status": "A",
        "authorized_official_last_name": "NA",
        "authorized_official_first_name": "DOE",
        "authorized_official_middle_name": "MYUNG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-343-3916",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "29391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL",
            "identifier": "B29391-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Reseda, CA
• Providers in Reseda, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; 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.