Individual provider Active NPI

Ga Young Suh

  • Pediatric Dentistry
  • Newton, NJ
National Provider Identifier
1780119511
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
22DI02702400 Issued in NJ
Practice address
11 Lawrence Rd
Newton, NJ 07860
Phone
(973) 300-0002
NPI assigned
Apr 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 22DI02702400 NJ Primary

Addresses

Primary practice location

11 Lawrence Rd
Newton, NJ 07860

Mailing address

47 Cambridge Ter Apt 47a
Hackensack, NJ 07601-8525
Phone (201) 410-0577

Other practice location 1

110 Bergen St
Newark, NJ 07103-2495
Phone (973) 972-4621

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
22DI02702400NJMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1493510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1780119511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 CAMBRIDGE TER APT 47A",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076018525",
            "telephone_number": "201-410-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 LAWRENCE RD",
            "city": "NEWTON",
            "state": "NJ",
            "postal_code": "07860",
            "telephone_number": "973-300-0002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Bergen St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071032495",
            "country_code": "US",
            "telephone_number": "973-972-4621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUH",
        "first_name": "GA",
        "middle_name": "YOUNG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-30",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02702400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; 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.