Individual provider Active NPI

Hee Song Seo, DDS

  • Dentist
  • San Ramon, CA
National Provider Identifier
1245468958
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
59765 Issued in CA
Practice address
12677 Alcosta Blvd Ste 525
San Ramon, CA 94583-4423
Phone
(925) 301-8220
NPI assigned
Jul 1, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 59765 CA Primary

Addresses

Primary practice location

12677 Alcosta Blvd Ste 525
San Ramon, CA 94583-4423

Mailing address

12677 Alcosta Blvd Ste 525
San Ramon, CA 94583-4423
Phone (925) 301-8220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150717002764 CA Order and Referring Only - DentistPractitioner - Dentist 5496068587

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
59765CAMDDentist

Interoperability endpoints

  • Direct secure messaging: hsseo@direct.westerndental.com

NPI Registry JSON

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1245468958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12677 ALCOSTA BLVD STE 525",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945834423",
            "telephone_number": "925-301-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12677 ALCOSTA BLVD STE 525",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945834423",
            "telephone_number": "925-301-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEO",
        "first_name": "HEE SONG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-01",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "59765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ramon, CA

Sources for this page

Verify at the official NPI Registry.