Active NPI
C Spencer Ahn, DDS
- Dentist
- East Northport, NY
National Provider Identifier
1821293960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 046314
- Practice address
- 7 El Paso CT
East Northport, NY 11731 - Phone
- (631) 499-1100
- NPI assigned
- Jun 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 046314 | NY | Primary |
Addresses
Primary practice location
7 El Paso CT
East Northport, NY 11731
Mailing address
7 El Paso Court
East Northport, NY 11731
Phone (631) 499-1100
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 |
|---|---|---|---|
| 046314 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821293960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 EL PASO COURT",
"city": "EAST NORTHPORT",
"state": "NY",
"postal_code": "11731",
"telephone_number": "631-499-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 EL PASO CT",
"city": "EAST NORTHPORT",
"state": "NY",
"postal_code": "11731",
"telephone_number": "631-499-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHN",
"first_name": "C",
"middle_name": "SPENCER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "046314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Northport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.