Active NPI
Hong Beom Moon, DDS, MS, FICD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Los Angeles, CA
National Provider Identifier
1336420165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 38095
- Practice address
- 3700 Wilshire Blvd Ste 770
Smile World Orthodontics
Los Angeles, CA 90010-3008 - Phone
- (213) 365-2828
- Fax
- (213) 365-2822
- NPI assigned
- Sep 7, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 38095 | CA | Primary |
Addresses
Primary practice location
3700 Wilshire Blvd Ste 770
Smile World Orthodontics
Los Angeles, CA 90010-3008
Mailing address
3700 Wilshire Blvd Ste 770
Smile World Orthodontics
Los Angeles, CA 90010-3008
Phone (213) 365-2828
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38095 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493856000000",
"number": "1336420165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3700 WILSHIRE BLVD STE 770",
"address_2": "SMILE WORLD ORTHODONTICS",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900103008",
"telephone_number": "213-365-2828",
"fax_number": "213-365-2822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 WILSHIRE BLVD STE 770",
"address_2": "SMILE WORLD ORTHODONTICS",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900103008",
"telephone_number": "213-365-2828",
"fax_number": "213-365-2822"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOON",
"first_name": "HONG",
"middle_name": "BEOM",
"name_prefix": "Dr.",
"credential": "DDS, MS, FICD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-07",
"last_updated": "2017-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "38095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.