Johan The, D.D.S., M.M.SC.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

3532 Issued in NJ

Practice address

105 N Dean St
Englewood, NJ 07631-2813

Phone

(201) 569-3232

NPI assigned

Jun 14, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328227200000",
    "number": "1801090543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2237",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070240497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N DEAN ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312813",
            "telephone_number": "201-569-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THE",
        "first_name": "JOHAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.M.SC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2012-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NJ",
            "license": "3532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endodontics in Englewood, NJ
• Providers in Englewood, NJ by specialty
• Endodontics in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2012; 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.