Sang Kwon Seo

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

33138 Issued in TX

Practice address

12989 Jupiter Rd Ste 106
Dallas, TX 75238-5248

Phone

(214) 343-9115

NPI assigned

Apr 20, 2016

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• SNC Dental, PLLC

  dba Heyday Family Dental

  • General Practice Dentistry
  • Fort Worth, TX
  • NPI 1609561224
  NPD Authorized official

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1427402981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12989 JUPITER RD STE 106",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752385248",
            "telephone_number": "214-343-9115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12989 JUPITER RD STE 106",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752385248",
            "telephone_number": "214-343-9115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-920-4321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEO",
        "first_name": "SANG KWON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "33138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sensory in Motion
• Richard David Sentelle, D.M.D./PH.D.
• Sentinel Home Health Inc
• Sentry Transportation
• Neil N Senzer, MD
• Dan Sepdham, M.D.
• September Services, LLC (September Services)
• Spencer Juan Septien
• Pamela Ann Sepulvado, MCD CCC-SLP
• Ricardo Sepulveda

• General Practice Dentistry in Dallas, TX
• Providers in Dallas, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.