Philip Hyun Son, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2021022285 Issued in NV

Practice address

4320 Osage Beach Pkwy
Osage Beach, MO 65065-2199

Phone

(323) 787-9397

NPI assigned

Jun 16, 2021

Last updated

Jun 16, 2021By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Provide Dental

  dba Provide Dental- Chesterfield

  • Dental Clinic/Center
  • Chesterfield, MO
  • NPI 1124990601
  Authorized official Same address or phone
• Provide Dental

  • Dental Clinic/Center
  • Saint Louis, MO
  • NPI 1760253694
  NPD (past) Authorized official
• Provide Dental

  dba Provide Dental- Chesterfield

  • Dental Clinic/Center
  • Chesterfield, MO
  • NPI 1952292005
  NPD (past) Authorized official
• Ads Osage Beach LP

  • Dental Clinic/Center
  • Osage Beach, MO
  • NPI 1144095100
  NPD
• Access Dental Services LP

  dba Access Dental & Dentures

  • General Practice Dentistry
  • Osage Beach, MO
  • NPI 1821386459
  NPD (past)

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1124696083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 OSAGE BEACH PKWY",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650652199",
            "telephone_number": "573-348-1466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 OSAGE BEACH PKWY",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650652199",
            "telephone_number": "323-787-9397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SON",
        "first_name": "PHILIP",
        "middle_name": "HYUN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "2021022285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachandeep Singh, MD
• Loretta Mae Skelton, PLPC
• Frederick M Smeltzer, M.D.
• Ann Kathryn Sochor, PTA
• Harjyot S Sohal, MD
• Cathy A Spetek, RD LD
• Brenda Renee Spies, PHARM D.
• Springfield Neurological and Spine Institute
• Mark B Stevens, PSYD
• Brooke Elizabeth Stone, COTA/L

• General Practice Dentistry in Osage Beach, MO
• Providers in Osage Beach, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.