Daniel Oh, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

021.003070 Issued in IL

Practice address

7500 Green Bay Rd Ste 200
Kenosha, WI 53142-4045

Phone

(714) 452-7178

NPI assigned

Aug 21, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Highland Park Endodontics

  • Endodontics
  • Highland Park, IL
  • NPI 1043097348
  NPD (past)
• Highland Park Endodontics, LTD.

  • Endodontics
  • Highland Park, IL
  • NPI 1659464378
  NPD (past)

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1689073041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 GREEN BAY RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531424059",
            "telephone_number": "714-452-7178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 GREEN BAY RD STE 200",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531424045",
            "telephone_number": "714-452-7178"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Central Ave Ste 250",
            "address_purpose": "LOCATION",
            "city": "Highland Park",
            "state": "IL",
            "postal_code": "600355611",
            "country_code": "US",
            "telephone_number": "847-433-5155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OH",
        "first_name": "DANIEL",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-21",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "9094724-9921",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6001145-15",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.031524",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": "021.003070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Abigail Jean Olcott, RD
• Kimberly Ann Oleksak, MSCC, LPC
• Jeanne E Olsen, PA-C
• Melissa M Olsen, LCPC

• Endodontics in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Endodontics in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.