Individual provider Active NPI

Chungeun Oh

  • Specialist
  • Malden, MA
National Provider Identifier
1902065568
Registry record updated Jun 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
26841 Issued in CA
Practice address
40 Eastern Ave
Malden, MA 02148-5014
Phone
(180) 076-0519
NPI assigned
Jun 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 26841 CA Primary

Addresses

Primary practice location

40 Eastern Ave
Malden, MA 02148-5014

Mailing address

7501 13TH Hole Dr
Windsor, CA 95492-9788

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

LicenseStateTypeSpecialty
26841CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1212883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212883200000",
    "number": "1902065568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 13TH HOLE DR",
            "city": "WINDSOR",
            "state": "CA",
            "postal_code": "954929788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 EASTERN AVE",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485014",
            "telephone_number": "180-076-0519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OH",
        "first_name": "CHUNGEUN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-08",
        "last_updated": "2008-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "26841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2008; 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.