Active NPI
Jin Ha Joung, D.M.D.
- Prosthodontics
- Ridgewood, NJ
National Provider Identifier
1790945038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 22DI02373200
- Practice address
- 166 Franklin Ave
Ridgewood, NJ 07450-3206 - Phone
- (201) 652-2474
- NPI assigned
- Jun 10, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 22DI02373200 | NJ | |
| Prosthodontics | 1223P0700X | 22DI02373200 | NJ | Primary |
Addresses
Primary practice location
166 Franklin Ave
Ridgewood, NJ 07450-3206
Mailing address
166 Franklin Ave
Ridgewood, NJ 07450-3206
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 |
|---|---|---|---|
| 22DI02373200 | NJ | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ridgewood Dental Associates, LLC | Periodontics | Past | 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": "1213056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213056000000",
"number": "1790945038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "166 FRANKLIN AVE",
"city": "RIDGEWOOD",
"state": "NJ",
"postal_code": "074503206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "166 FRANKLIN AVE",
"city": "RIDGEWOOD",
"state": "NJ",
"postal_code": "074503206",
"telephone_number": "201-652-2474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOUNG",
"first_name": "JIN HA",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-10",
"last_updated": "2008-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NJ",
"license": "22DI02373200",
"primary": false
},
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "NJ",
"license": "22DI02373200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.