Individual provider Active NPI

Jung-Hyun Huh, DDS

  • Dentist
  • Rancho Mirage, CA
National Provider Identifier
1922657394
Registry record updated Sep 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
104409 Issued in CA
Practice address
71817 Highway 111 Ste 1
Rancho Mirage, CA 92270-4487
Phone
(917) 724-5987
NPI assigned
Sep 9, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 104409 CA Primary

Addresses

Primary practice location

71817 Highway 111 Ste 1
Rancho Mirage, CA 92270-4487

Mailing address

43100 Palm Royale Dr Apt 1215
La Quinta, CA 92253-4901
Phone (917) 724-5987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200401001155 CA Order and Referring Only - DentistPractitioner - Dentist 9739518457

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104409CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1922657394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43100 PALM ROYALE DR APT 1215",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922534901",
            "telephone_number": "917-724-5987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71817 HIGHWAY 111 STE 1",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704487",
            "telephone_number": "917-724-5987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUH",
        "first_name": "JUNG-HYUN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-09",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "104409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.