Individual provider Active NPI

Joshua Jihun Sok, DDS

  • Dentist
  • Round Rock, TX
National Provider Identifier
1235697400
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
36301 Issued in TX
Practice address
1780 Round Rock Ave Ste 100
Round Rock, TX 78681-4069
Phone
(512) 341-7500
NPI assigned
Mar 6, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 36301 TX Primary

Addresses

Primary practice location

1780 Round Rock Ave Ste 100
Round Rock, TX 78681-4069

Mailing address

3705 Grandview Dr
Carrollton, TX 75007-1937

Other practice location 1

200 Belle Terre Rd
Port Jefferson, NY 11777-1928
Phone (631) 474-6553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190724003451 NY Order and Referring Only - DentistPractitioner - Dentist 7416283742

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36301TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1235697400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 GRANDVIEW DR",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750071937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 ROUND ROCK AVE STE 100",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814069",
            "telephone_number": "512-341-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Belle Terre Rd",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117771928",
            "country_code": "US",
            "telephone_number": "631-474-6553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOK",
        "first_name": "JOSHUA",
        "middle_name": "JIHUN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-06",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "36301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.