Individual provider Active NPI

Mark In Huh, DMD

  • Dentist
  • Cinnaminson, NJ
National Provider Identifier
1851687792
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI02501300 Issued in NJ
Practice address
700 Route 130 N Ste 204
Cinnaminson, NJ 08077-3366
Phone
(856) 829-8668
NPI assigned
Jun 20, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS037953 PA
Dentist 122300000X 22DI02501300 NJ Primary

Addresses

Primary practice location

700 Route 130 N Ste 204
Cinnaminson, NJ 08077-3366

Mailing address

700 Route 130 N Ste 204
Cinnaminson, NJ 08077-3366
Phone (856) 829-8668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171018003134 NJ Order and Referring Only - DentistPractitioner - Oral SurgeryPractitioner - Dentist 4789950783

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02501300NJMDDentist
DS037953PAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Rapha Dental LLC CurrentSince Jan 21, 2022 Accepting new patients

Locations

700 Route 130 N
Ste 204
Cinnaminson, NJ 08077
Phone (856) 829-8668

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": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1851687792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ROUTE 130 N STE 204",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "080773366",
            "telephone_number": "856-829-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 ROUTE 130 N STE 204",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "080773366",
            "telephone_number": "856-829-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUH",
        "first_name": "MARK",
        "middle_name": "IN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-20",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS037953",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02501300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cinnaminson, NJ

Sources for this page

Verify at the official NPI Registry.