Active NPI
Hogeun CHI
- General Practice Dentistry
- Moline, IL
National Provider Identifier
1659840908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019.031934
- Practice address
- 4601 16TH St
Moline, IL 61265-7000 - Phone
- (309) 797-0888
- NPI assigned
- Nov 15, 2018
- 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 | 019.031934 | IL | Primary |
Addresses
Primary practice location
4601 16TH St
Moline, IL 61265-7000
Mailing address
3215 Friendship Dr
Rock Island, IL 61201-6152
Phone (929) 600-4973
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019.031934 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.031934 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542240000000",
"number": "1659840908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3215 FRIENDSHIP DR",
"city": "ROCK ISLAND",
"state": "IL",
"postal_code": "612016152",
"telephone_number": "929-600-4973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4601 16TH ST",
"city": "MOLINE",
"state": "IL",
"postal_code": "612657000",
"telephone_number": "309-797-0888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHI",
"first_name": "HOGEUN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-15",
"last_updated": "2018-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019.031934",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "019.031934",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Moline, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.