Individual provider Active NPI

Myungjin Sohn, DDS

  • General Practice Dentistry
  • San Marino, CA
National Provider Identifier
1184351967
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS106950 Issued in CA
Practice address
1477 San Marino Ave Ste 1
San Marino, CA 91108-2053
Phone
(626) 399-0448
NPI assigned
Aug 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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 DDS106950 CA Primary

Addresses

Primary practice location

1477 San Marino Ave Ste 1
San Marino, CA 91108-2053

Mailing address

2615 Greenfield Ave
Arcadia, CA 91006-5232
Phone (626) 394-3742

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
DDS106950CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1184351967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 GREENFIELD AVE",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910065232",
            "telephone_number": "626-394-3742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1477 SAN MARINO AVE STE 1",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911082053",
            "telephone_number": "626-399-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOHN",
        "first_name": "MYUNGJIN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-02",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS106950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; 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.