Kyoung Han Bae, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

064016 Issued in NY

Practice address

116 Broadway
Malverne, NY 11565-1635

Phone

(917) 484-0986

NPI assigned

Jul 16, 2019

Last updated

Feb 13, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Kyoung Han Bae DDS P.C.

  dba Cornerstone Dental

  • Dental Clinic/Center
  • Malverne, NY
  • NPI 1962207134
  NPD Authorized official

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1750933073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 BROADWAY",
            "city": "MALVERNE",
            "state": "NY",
            "postal_code": "115651635",
            "telephone_number": "917-484-0986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 BROADWAY",
            "city": "MALVERNE",
            "state": "NY",
            "postal_code": "115651635",
            "telephone_number": "917-484-0986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAE",
        "first_name": "KYOUNG HAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-16",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1858395",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "064016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Ammendola, LCSW
• Amanda Angilletta
• Lisa K Askinazi, PH.D.
• Myrlene Azor-Jean
• Linda M. Babolcsay, L.C.S.W., C.A.S.A.C
• Tara Marie Baker, MS./ED.
• Lauren Marie Baron
• Chestine Barrett
• Nancy Beattty, SLP
• Melody Garcia Bernabe, NP

• Dentist in Malverne, NY
• Providers in Malverne, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; 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.