Active NPI
Hans Roy Joo, DMD
- Dentist
- Los Angeles, CA
National Provider Identifier
1861614026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 53604
- Practice address
- 1633 S Bentley Ave
#201
Los Angeles, CA 90025-3587 - Phone
- (310) 871-1355
- NPI assigned
- May 3, 2007
- Last updated
- Apr 21, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 53604 | CA | Primary |
Addresses
Primary practice location
1633 S Bentley Ave
#201
Los Angeles, CA 90025-3587
Mailing address
1633 S Bentley Ave
#201
Los Angeles, CA 90025-3587
Phone (310) 871-1355
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 |
|---|---|---|---|
| 53604 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271808000000",
"number": "1861614026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1633 S BENTLEY AVE",
"address_2": "#201",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900253587",
"telephone_number": "310-871-1355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1633 S BENTLEY AVE",
"address_2": "#201",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900253587",
"telephone_number": "310-871-1355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOO",
"first_name": "HANS",
"middle_name": "ROY",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-03",
"last_updated": "2010-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "53604",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.