MR. TAE-JU OH DDS MS
NPI 1952494163
Dentist - Periodontics in Warren, MI

Q: What is Tae-ju Oh's NPI number?

The NPI number for Tae-ju Oh is 1952494163. It was assigned to this individual provider in the NPPES registry on October 2, 2006.

Q: What is Tae-ju Oh's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Q: When was this NPI record last updated?

The NPPES record for Tae-ju Oh was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 02, 2006PECOS Enrolled

13403 13 MILE RD, WARREN, MI 48088(586) 979-2800(586) 979-2720 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Mr. Tae-ju Oh Dds Ms NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. TAE-JU OH DDS MS (NPI 1952494163) is an individual periodontics provider in Warren, Michigan, licensed in Michigan (2901018175) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1952494163

Entity TypeIndividualMale

Primary Taxonomy1223P0300X

Provider Legal NameMR. TAE-JU OHCredential: DDS MS

Location Address13403 13 MILE RDWarren, MI 48088

Mailing Address13403 13 Mile RdWarren, MI 48088 · (586) 979-2800 · Fax (586) 979-2720

Phone(586) 979-2800

Fax(586) 979-2720

Sole ProprietorNo

Enumeration DateOctober 2, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1952494163 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

License✔ Licensed in MI · 2901018175

Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

13403 13 MILE RD, Warren, MI 48088

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Tae-ju Oh Dds Ms is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48088 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$72.38 typical visit price

range $18.32 – $143.49

Typical copayment $18.09 (range $4.58 – $35.87)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. MARK A BOUCHILLON DDS

Dentist