Glenn Jaewon Oh, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

BP10087365 Issued in TX

Practice address

5323 Harry Hines Blvd Stop 7200
Dallas, TX 75390-7200

Phone

(214) 648-3433

NPI assigned

Mar 25, 2024

Sex

Male

Sole proprietor

No

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

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: goh802246@direct.childrens.com

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1811747579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 CHATSWORTH DR",
            "city": "AMBLER",
            "state": "PA",
            "postal_code": "190021866",
            "telephone_number": "267-261-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD STOP 7200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907200",
            "telephone_number": "214-648-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OH",
        "first_name": "GLENN",
        "middle_name": "JAEWON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10087365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Ogwu
• Oh-Labs LLC (Optimal Health Laboratories)
• Leia Fine Oh-Spradling, RN, ACNP
• Emily Oh
• Emma Oh
• Grace Oh, MD
• Ilkyu David Oh, MD
• Jonathan Chun Oh, MD
• Matthew Wonshik Oh
• Michael C Oh, M.D. PHD.

• Student in an Organized Health Care Education/Training Program in Dallas, TX
• Providers in Dallas, TX by specialty
• Student in an Organized Health Care Education/Training Program in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.