Individual provider Active NPI

Jangwon Huh, D.M.D.

  • General Practice Dentistry
  • Billerica, MA
National Provider Identifier
1780979989
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN1855668 Issued in MA
Practice address
790 Boston Rd
Ste 201
Billerica, MA 01821-5919
Phone
(617) 576-5300
NPI assigned
Jun 15, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

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 DN1855668 MA Primary

Addresses

Primary practice location

790 Boston Rd
Ste 201
Billerica, MA 01821-5919

Mailing address

790 Boston Rd
Ste 201
Billerica, MA 01821-5919
Phone (617) 576-5300

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
DN1855668MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Promise Dental Group, PLLC Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1780979989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 BOSTON RD",
            "address_2": "STE 201",
            "city": "BILLERICA",
            "state": "MA",
            "postal_code": "018215919",
            "telephone_number": "617-576-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 BOSTON RD",
            "address_2": "STE 201",
            "city": "BILLERICA",
            "state": "MA",
            "postal_code": "018215919",
            "telephone_number": "617-576-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUH",
        "first_name": "JANGWON",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-15",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1855668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Billerica, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; 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.