Joyce Jayoung Koh, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

019026966 Issued in IL

Practice address

45 S Park Blvd
Suite 105
Glen Ellyn, IL 60137-6280

Phone

(630) 858-8755

Fax

(630) 858-6204

NPI assigned

Nov 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Glen Ellyn Pediatric Dentistry ,P.C..

  • Pediatric Dentistry
  • Glen Ellyn, IL
  • NPI 1043390792
  NPD (past)

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261094400000",
    "number": "1962681361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 S PARK BLVD",
            "address_2": "SUITE 105",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601376280",
            "telephone_number": "630-858-8755",
            "fax_number": "630-858-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 S PARK BLVD",
            "address_2": "SUITE 105",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601376280",
            "telephone_number": "630-858-8755",
            "fax_number": "630-858-6204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOH",
        "first_name": "JOYCE",
        "middle_name": "JAYOUNG",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-01",
        "last_updated": "2009-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "019026966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Klinger, MD
• Noor Musa Kljako
• April Abesamis Knighton, LCPC
• Jami Gabrielle Knopp, PA-C
• Karen A. Koenig, D.T.
• Heather Ann Koopmann, AU.D.
• Christopher Kosapatti, RPH
• Barbara Kosirog
• Cynthia Koskiewicz, LCPC
• Laura Koziej, MA, LPC

• Pediatric Dentistry in Glen Ellyn, IL
• Providers in Glen Ellyn, IL by specialty
• Pediatric Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2009; 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.