Organization Active NPI

Glimmer Orthodontics PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Salem, NH
National Provider Identifier
1629882519
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
GLIMMER ORTHODONTICS PLLC
Practice address
25 Pelham Rd Ste 104
Salem, NH 03079-4872
Phone
(603) 912-7878
Fax
(603) 912-7572
NPI assigned
Feb 3, 2025
Last updated
Feb 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Authorized official

Name
Dr. Ji Hyun Tahk, DMD, MS
Title
Owner Dentist
Phone
(603) 912-7878

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X NU Primary

Addresses

Primary practice location

25 Pelham Rd Ste 104
Salem, NH 03079-4872

Mailing address

25 Pelham Rd Ste 104
Salem, NH 03079-4872
Phone (603) 912-7878

Other identifiers 1

IdentifierTypeStateIssuer
04811OtherNHDENTAL LICENSE

National Provider Directory

National Provider Directory

Locations

25 Pelham Rd
Ste 104
Salem, NH 03079
Phone (603) 870-9618

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738540800000",
    "number": "1629882519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 PELHAM RD STE 104",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030794872",
            "telephone_number": "603-912-7878",
            "fax_number": "603-912-7572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 PELHAM RD STE 104",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030794872",
            "telephone_number": "603-912-7878",
            "fax_number": "603-912-7572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLIMMER ORTHODONTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A",
        "authorized_official_last_name": "TAHK",
        "authorized_official_first_name": "JI",
        "authorized_official_middle_name": "HYUN",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "603-912-7878",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "04811",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; 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.