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General NPI Number Information
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NPI Number | 1487932547
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Entity Type | Individual
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Provider Name | KEVIN OH D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/23/2011
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Last Update Date | 04/17/2022
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Provider Practice Location Address
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Address Line | 170 BROOKLINE AVE UNIT 517
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City | BOSTON
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State | MA
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Zip | 02215-3937
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Country | US
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Telephone | 321-287-8346
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Fax |
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Provider Business Mailing Address
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Address Line | 130 PADDLE CT
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-4804
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Country | US
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Telephone | 321-287-8346
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN1855931
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN015150
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License Number State | GA
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