NPIMap

Individual provider Active NPI

Keechun Hong, D.M.D.

  • General Practice Dentistry
  • Laurel, MD
National Provider Identifier
1700931748
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13169 Issued in MD
Practice address
1003 4TH St
Laurel, MD 20707-3801
Phone
(301) 725-1002
Fax
(301) 725-1150
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13169 MD Primary

Addresses

Primary practice location

1003 4TH St
Laurel, MD 20707-3801

Mailing address

1003 4TH St
Laurel, MD 20707-3801
Phone (301) 725-1002

Other practice location 1

10176 Baltimore National Pike Ste 209
Ellicott City, MD 21042-3652
Phone (410) 480-5234

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

LicenseStateTypeSpecialty
13169MDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1700931748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 4TH ST",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207073801",
            "telephone_number": "301-725-1002",
            "fax_number": "301-725-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 4TH ST",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207073801",
            "telephone_number": "301-725-1002",
            "fax_number": "301-725-1150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10176 Baltimore National Pike Ste 209",
            "address_purpose": "LOCATION",
            "city": "Ellicott City",
            "state": "MD",
            "postal_code": "210423652",
            "country_code": "US",
            "telephone_number": "410-480-5234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HONG",
        "first_name": "KEECHUN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "13169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; 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.