Dong Heon Oh, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN21290 Issued in MA

Practice address

305 W Grand Ave Ste 600
Montvale, NJ 07645-1829

Phone

(201) 746-9910

Fax

(201) 746-9909

NPI assigned

May 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

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.

• Dong Heon Oh DDS PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Montvale, NJ
  • NPI 1851954416
  NPD Authorized official
• Oh Orthodontics DDS PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Englewood Cliffs, NJ
  • NPI 1073429866
  NPD (past) Authorized official
• Icon DPMG LLC

  • General Practice Dentistry
  • Lexington, MA
  • NPI 1134331424
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1699981670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 W GRAND AVE STE 600",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451829",
            "telephone_number": "201-746-9910",
            "fax_number": "201-746-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W GRAND AVE STE 600",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451829",
            "telephone_number": "201-746-9910",
            "fax_number": "201-746-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OH",
        "first_name": "DONG HEON",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21290",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "22DI02713100",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MA",
            "license": "DN21290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110072945A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oh@montvaleortho.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "305 W Grand Ave Ste 600",
            "city": "Montvale",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "076451829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Montvale, NJ
• Providers in Montvale, NJ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.