Individual provider Active NPI

Sung Woo Cho, DDS

  • General Practice Dentistry
  • New London, CT
National Provider Identifier
1003384975
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12380 Issued in CT
Practice address
258 S Frontage Rd
New London, CT 06320-2641
Phone
(860) 437-3462
NPI assigned
Nov 8, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12380 CT Primary

Addresses

Primary practice location

258 S Frontage Rd
New London, CT 06320-2641

Mailing address

258 S Frontage Rd
New London, CT 06320-2641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12380CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New London Dental Care, LLC General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1003384975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 S FRONTAGE RD",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063202641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 S FRONTAGE RD",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063202641",
            "telephone_number": "860-437-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHO",
        "first_name": "SUNG WOO",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-08",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "12380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; 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.