Individual provider Active NPI

James Bum-Suk Han, D.D.S, M.D.

  • Dentist
  • Pleasant Hill, CA
National Provider Identifier
1013221324
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D100039 Issued in CA
Practice address
401 Gregory Lane
Suite 208
Pleasant Hill, CA 94523
Phone
(925) 689-8500
NPI assigned
Jul 28, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D100039 CA Primary

Addresses

Primary practice location

401 Gregory Lane
Suite 208
Pleasant Hill, CA 94523

Mailing address

401 Gregory Lane
Suite 208
Pleasant Hill, CA 94523
Phone (925) 689-8500

Other identifiers 1

IdentifierTypeStateIssuer
ENROLLEDMedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180409001482 CA Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 6103010111 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D100039CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
John Muir Trauma Physicians Billing Service CurrentSince Jan 28, 2018 Accepting new patients
John Muir Trauma Physicians Billing Service Current Accepting new patients

Locations

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Organizations & group practices 2

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": "1280275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1013221324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 GREGORY LANE",
            "address_2": "SUITE 208",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "94523",
            "telephone_number": "925-689-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 GREGORY LANE",
            "address_2": "SUITE 208",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "94523",
            "telephone_number": "925-689-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "JAMES",
        "middle_name": "BUM-SUK",
        "name_prefix": "Dr.",
        "credential": "D.D.S, M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "D100039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Hill, CA

Sources for this page

Verify at the official NPI Registry.