Sung Hyun Nam, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

15230897 Issued in CT

Practice address

711 Canal St
Stamford, CT 06902-6094

Phone

(203) 490-6226

NPI assigned

Jan 16, 2020

Sex

Male

Sole proprietor

Yes

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 CT

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

State licenses

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

{
    "created_epoch": "1579132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1104456318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 TOWNE ST UNIT 114",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069025994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 CANAL ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069026094",
            "telephone_number": "203-490-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAM",
        "first_name": "SUNG",
        "middle_name": "HYUN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-16",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "15230897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen S Naidorf, M.D.
• Dawn Marie Nair, A.P.R.N.
• Kunjal Nair, PHARMACIST
• Shehryar Najeeb, MD
• Soohyun Nam
• Draupathi E Nambudiri, MD
• Desh Sanjeev Nandedkar, M.D.
• Christopher Athanasios Nanos, D.P.T.
• Kevin Naranjo
• Krishnan Narasimhan, M.D.

• Dentist in Stamford, CT
• Providers in Stamford, CT by specialty
• Dentist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; 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.