Individual provider Active NPI

Sean Hwang, DDS

  • Periodontics
  • Woodinville, WA
National Provider Identifier
1356902217
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
12030 Issued in TN
Practice address
13515 NE 175TH St Ste B
Woodinville, WA 98072-8566
Phone
(425) 217-8797
NPI assigned
Jun 21, 2019
Last updated
Aug 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401418162 VA
Periodontics 1223P0300X 12030 TN Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

13515 NE 175TH St Ste B
Woodinville, WA 98072-8566

Mailing address

15843 NE 83Rd Way
Redmond, WA 98052-3887
Phone (617) 735-5201

Other practice location 1

1 Kneeland St
Boston, MA 02111-1527
Phone (617) 636-6828

Other practice location 2

125 Wendelwood Dr Ste B
Murfreesboro, TN 37129-3746
Phone (615) 904-1585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20191202001753 MA Order and Referring Only - DentistPractitioner - Dentist 8527491737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401418162VAMDDentist
12030TNMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Murfreesboro Smiles Dentistry, PC Dentist PastSince Nov 1, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1356902217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15843 NE 83RD WAY",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523887",
            "telephone_number": "617-735-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13515 NE 175TH ST STE B",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980728566",
            "telephone_number": "425-217-8797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Kneeland St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021111527",
            "country_code": "US",
            "telephone_number": "617-636-6828",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 Wendelwood Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "371293746",
            "country_code": "US",
            "telephone_number": "615-904-1585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HWANG",
        "first_name": "SEAN",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-21",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401418162",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TN",
            "license": "12030",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodinville, WA

Sources for this page

Verify at the official NPI Registry.