Active NPI
Simon Seihoon Cheong, DDS
- Dentist
- Los Angeles, CA
National Provider Identifier
1073011565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 101940
- Practice address
- 2105 Beverly Blvd Ste 101
Los Angeles, CA 90057-2248 - Phone
- (213) 484-1288
- NPI assigned
- Jan 30, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 101940 | CA | Primary |
Addresses
Primary practice location
2105 Beverly Blvd Ste 101
Los Angeles, CA 90057-2248
Mailing address
11 Estrella
Irvine, CA 92614-8109
Phone (310) 892-3810
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
| License | State | Type | Specialty |
|---|---|---|---|
| 101940 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Laddaran Dental Corp | Past | Accepting new patients | |
| Jay J. Chobdee, DDS a Professional Corporation | Dentist | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dentist
- Los Angeles, CA
- NPI 1225307382
-
- General Practice Dentistry
- Los Angeles, CA
- NPI 1558427815
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517270400000",
"number": "1073011565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 ESTRELLA",
"city": "IRVINE",
"state": "CA",
"postal_code": "926148109",
"telephone_number": "310-892-3810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2105 BEVERLY BLVD STE 101",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900572248",
"telephone_number": "213-484-1288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEONG",
"first_name": "SIMON",
"middle_name": "SEIHOON",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-30",
"last_updated": "2018-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "101940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.