Active NPI
Kyung Won Seo, D.M.D
- General Practice Dentistry
- Dorchester, MA
National Provider Identifier
1306077615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN1855174
- Practice address
- 653 Columbia Rd
Dorchester, MA 02125-1712 - Phone
- (617) 776-7576
- Fax
- (617) 825-5006
- NPI assigned
- Aug 4, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN1855174 | MA | Primary |
Addresses
Primary practice location
653 Columbia Rd
Dorchester, MA 02125-1712
Mailing address
653 Columbia Rd
Dorchester, MA 02125
Phone (617) 776-7576
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN1855174 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249344000000",
"number": "1306077615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "653 COLUMBIA RD",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "02125",
"telephone_number": "617-776-7576",
"fax_number": "617-825-5006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "653 COLUMBIA RD",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "021251712",
"telephone_number": "617-776-7576",
"fax_number": "617-825-5006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEO",
"first_name": "KYUNG WON",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-04",
"last_updated": "2009-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "DN1855174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dorchester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.