Individual provider Active NPI

Seung Han, D.M.D

  • General Practice Dentistry
  • Bakersfield, CA
National Provider Identifier
1164545125
Registry record updated Jan 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
52058 Issued in CA
Practice address
4450 Coffee Rd
2A
Bakersfield, CA 93308-5032
Phone
(661) 679-6997
Fax
(661) 679-6998
NPI assigned
Apr 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 52058 CA Primary

Addresses

Primary practice location

4450 Coffee Rd
2A
Bakersfield, CA 93308-5032

Mailing address

4450 Coffee Rd
2A
Bakersfield, CA 93308-5032
Phone (213) 595-5029

Other identifiers 1

IdentifierTypeStateIssuer
D52058OtherCADENTICAL PROVIDER NUMBER

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

LicenseStateTypeSpecialty
52058CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Seung Han DMD, Inc Past Accepting new patients

Organizations & group practices 1

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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389916800000",
    "number": "1164545125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 COFFEE RD",
            "address_2": "2A",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933085032",
            "telephone_number": "213-595-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 COFFEE RD",
            "address_2": "2A",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933085032",
            "telephone_number": "661-679-6997",
            "fax_number": "661-679-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "SEUNG",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2014-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "52058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL PROVIDER NUMBER",
            "identifier": "D52058",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2014; 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.