Active NPI
Stephanie Haeyoung Oh, D.M.D
- Dentist
- Moline, IL
National Provider Identifier
1700262458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019030405
- Practice address
- 4404 16TH St
Moline, IL 61265-7012 - Phone
- (309) 948-6041
- NPI assigned
- Aug 5, 2015
- Last updated
- Aug 5, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 019030405 | IL | Primary |
Addresses
Primary practice location
4404 16TH St
Moline, IL 61265-7012
Mailing address
4554 7TH St Apt 6303
East Moline, IL 61244-4685
Phone (858) 735-4403
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 |
|---|---|---|---|
| 019030405 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438732800000",
"number": "1700262458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4554 7TH ST APT 6303",
"city": "EAST MOLINE",
"state": "IL",
"postal_code": "612444685",
"telephone_number": "858-735-4403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4404 16TH ST",
"city": "MOLINE",
"state": "IL",
"postal_code": "612657012",
"telephone_number": "309-948-6041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OH",
"first_name": "STEPHANIE",
"middle_name": "HAEYOUNG",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-05",
"last_updated": "2015-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019030405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moline, IL
- Occupational Health Centers of Illinois PC (dba, Concentra Medical Centers)
- Occupational Health Centers of Illinois PC (Concentra Medical Center)
- Occuspecialist, P.C.
- Monique Ochoa
- Nancy Offenhiser, CADC
- Ahmed F Okba, MD
- Kristen Olin, DNP-FNP
- Andrew D Olson Sr., MS.ED.,QMHP,LPC,NCC
- Toyosi Olutade, MD
- Oneopto Il 2 PLLC (All About Eyes)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.