Active NPI
Samuel Pyo, DDS
- Prosthodontics
- Ft Benning, GA
National Provider Identifier
1346487139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 57735
- Practice address
- 7101 Hoff Street
USA Dentac
Ft Benning, GA 31905 - Phone
- (706) 544-4530
- Fax
- (706) 544-1933
- NPI assigned
- Jan 15, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 57735 | CA | |
| Prosthodontics | 1223P0700X | 57735 | CA | Primary |
Addresses
Primary practice location
7101 Hoff Street
USA Dentac
Ft Benning, GA 31905
Mailing address
7101 Hoff Street
USA Dentac
Ft Benning, GA 31905
Phone (706) 544-4530
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 |
|---|---|---|---|
| 57735 | CA | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405036800000",
"number": "1346487139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7101 HOFF STREET",
"address_2": "USA DENTAC",
"city": "FT BENNING",
"state": "GA",
"postal_code": "31905",
"telephone_number": "706-544-4530",
"fax_number": "706-544-1933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7101 HOFF STREET",
"address_2": "USA DENTAC",
"city": "FT BENNING",
"state": "GA",
"postal_code": "31905",
"telephone_number": "706-544-4530",
"fax_number": "706-544-1933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PYO",
"first_name": "SAMUEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-15",
"last_updated": "2014-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "57735",
"primary": false
},
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "CA",
"license": "57735",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft Benning, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.