Individual provider Active NPI

Sung H Cho, D.M.D

  • Oral and Maxillofacial Surgery (Dentist)
  • Philadelphia, PA
National Provider Identifier
1952400780
Registry record updated Nov 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS030940L Issued in PA
Practice address
909 Walnut St
300 Cob
Philadelphia, PA 19107-5211
Phone
(215) 955-6215
Fax
(215) 923-9189
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS030940L PA Primary

Addresses

Primary practice location

909 Walnut St
300 Cob
Philadelphia, PA 19107-5211

Mailing address

615 Chestnut St
14TH Floor
Philadelphia, PA 19106-4404
Phone (215) 776-8923

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
I20120109000326 NJ Practitioner - Oral Surgery 0446323323 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Perelman School of Med at the University of Pennsylvania, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

171 Woodport Rd
Sparta, NJ 07871-2633
Phone (973) 729-7979

Hospital & facility affiliations

  • The University Hospital Hospital, Newark, NJ, CCN 310119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS030940LPAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health -University Dental Associates Oral and Maxillofacial Surgery CurrentSince Jul 1, 2013 Accepting new patients
Jefferson Medical Care, PC Oral and Maxillofacial Surgery PastSince Jun 8, 1992 Accepting new patients

Locations

90 Bergen St
Ste 7700
Newark, NJ 07103
Phone (973) 972-2444

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258070400000",
    "number": "1952400780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 CHESTNUT ST",
            "address_2": "14TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191064404",
            "telephone_number": "215-776-8923",
            "fax_number": "215-955-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 WALNUT ST",
            "address_2": "300 COB",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075211",
            "telephone_number": "215-955-6215",
            "fax_number": "215-923-9189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHO",
        "first_name": "SUNG",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2009-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS030940L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.