NPIMap

Organization Active NPI

Charm Pediatric Dentistry, LLC

  • Pediatric Dentistry
  • Blue Bell, PA
National Provider Identifier
1649439613
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DS030062L Issued in PA
Legal business name
CHARM PEDIATRIC DENTISTRY, LLC
Practice address
1040 Dekalb Pike
Suite 100
Blue Bell, PA 19422
Phone
(610) 277-4811
Fax
(610) 277-4896
NPI assigned
Jun 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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

Authorized official

Name
Dr. Yoosung Suh, D.M.D.NPI 1831119916
Title
Owner
Phone
(610) 277-4811

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X DS030062L PA Primary

Addresses

Primary practice location

1040 Dekalb Pike
Suite 100
Blue Bell, PA 19422

Mailing address

1040 Dekalb Pike
Suite 100
Blue Bell, PA 19422-1812
Phone (610) 277-4811

Other identifiers 2

IdentifierTypeStateIssuer
102099918001MedicaidPA
1831119916OtherPANPI

National Provider Directory

National Provider Directory

Locations

1040 DeKalb Pike
Ste 100
Blue Bell, PA 19422
Phone (610) 277-4811

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430784000000",
    "number": "1649439613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 DEKALB PIKE",
            "address_2": "SUITE 100",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194221812",
            "telephone_number": "610-277-4811",
            "fax_number": "610-277-4896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 DEKALB PIKE",
            "address_2": "SUITE 100",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "19422",
            "telephone_number": "610-277-4811",
            "fax_number": "610-277-4896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARM PEDIATRIC DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2015-05-05",
        "status": "A",
        "authorized_official_last_name": "SUH",
        "authorized_official_first_name": "YOOSUNG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-277-4811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS030062L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102099918001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1831119916",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Bell, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; 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.