Active NPI
Dae Kyu Hwang, DMD
- General Practice Dentistry
- New Haven, CT
National Provider Identifier
1528372109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 10327
- Practice address
- 531 Elm St
New Haven, CT 06511-4549 - Phone
- (860) 356-0057
- NPI assigned
- Aug 5, 2010
- 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 | 10327 | CT | Primary |
Addresses
Primary practice location
531 Elm St
New Haven, CT 06511-4549
Mailing address
1090 Northchase Pkwy SE
Suite 290
Marietta, GA 30067-6405
Phone (678) 904-5665
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- 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 |
|---|---|---|---|---|
| I20160803001612 | CT | Order and Referring Only - Oral Surgery | 6800180522 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10327 | CT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280966400000",
"number": "1528372109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1090 NORTHCHASE PKWY SE",
"address_2": "SUITE 290",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300676405",
"telephone_number": "678-904-5665",
"fax_number": "678-904-5666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "531 ELM ST",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065114549",
"telephone_number": "860-356-0057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HWANG",
"first_name": "DAE KYU",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-05",
"last_updated": "2010-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CT",
"license": "10327",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; 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.