Individual provider Active NPI

Sungmin Sohn

  • Pediatric Dentistry
  • Chapel Hill, NC
National Provider Identifier
1164091294
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
12999 Issued in NC
Practice address
1504 E Franklin St Ste 101
Chapel Hill, NC 27514-2820
Phone
(919) 967-2773
NPI assigned
Jun 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 12999 NC Primary

Addresses

Primary practice location

1504 E Franklin St Ste 101
Chapel Hill, NC 27514-2820

Mailing address

1504 E Franklin St Ste 101
Chapel Hill, NC 27514-2820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20220303000658 NC Order and Referring Only - DentistPractitioner - Dentist 5991199218

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Annelise Hardin, DDS, Ms, PA Pediatric Dentistry CurrentSince Oct 13, 2024 Accepting new patients
Adams School of Dentistry PastSince Jul 7, 2024 Accepting new patients
Unc School of Dentistry PastSince Jun 1, 2021 Accepting new patients

Locations

1504 E Franklin St
Ste 101
Chapel Hill, NC 27514
Phone (919) 967-2773

Organizations & group practices 3

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": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1164091294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 E FRANKLIN ST STE 101",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 E FRANKLIN ST STE 101",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142820",
            "telephone_number": "919-967-2773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOHN",
        "first_name": "SUNGMIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "12999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.