Active NPI
Won H Bae, DDS
- General Practice Dentistry
- Marlborough, MA
National Provider Identifier
1902012941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11783
- Practice address
- 320 Bolton St
Marlborough, MA 01752-3980 - Phone
- (508) 485-2278
- Fax
- (508) 485-0970
- NPI assigned
- May 15, 2007
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11783 | MA | Primary |
Addresses
Primary practice location
320 Bolton St
Marlborough, MA 01752-3980
Mailing address
320 Bolton St
Marlborough, MA 01752-3980
Phone (508) 485-2278
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902012941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 BOLTON ST",
"city": "MARLBOROUGH",
"state": "MA",
"postal_code": "017523980",
"telephone_number": "508-485-2278",
"fax_number": "508-485-0970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 BOLTON ST",
"city": "MARLBOROUGH",
"state": "MA",
"postal_code": "017523980",
"telephone_number": "508-485-2278",
"fax_number": "508-485-0970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAE",
"first_name": "WON",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "11783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marlborough, MA
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.