Seokjoon Pang, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

63799 Issued in CA

Practice address

133 Arch St Ste 4
Redwood City, CA 94062-1326

Phone

(650) 549-1155

Fax

(650) 549-6080

NPI assigned

Aug 5, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728086400000",
    "number": "1073922951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2576 OAK RD APT 206",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "94597",
            "telephone_number": "925-899-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 ARCH ST STE 4",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940621326",
            "telephone_number": "650-549-1155",
            "fax_number": "650-549-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANG",
        "first_name": "SEOKJOON",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-05",
        "last_updated": "2024-10-05",
        "certification_date": "2024-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Palm & Needle Medical Clinic
• Ian Palmer
• Owen Palmer, M.D.
• Tiffany Rae Palmer, RN
• Ying Pan, C MT
• Manuel Benedicto Paniagua, D.C.
• Aldo Salvador Pantoja
• Elizabeth S Papp, PA-C
• Eleni Pappas Hulman
• Heather Pappas, PT, OCS, CERT. DN

• Dentist in Redwood City, CA
• Providers in Redwood City, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.