Seung K Shon, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

53107 Issued in CA

Practice address

1329 Hwy 2
Ste C
Wrightwood, CA 92397

Phone

(760) 249-5411

Fax

(760) 249-3561

NPI assigned

Nov 2, 2007

Last updated

Jan 21, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358726400000",
    "number": "1437338753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3159",
            "city": "WRIGHTWOOD",
            "state": "CA",
            "postal_code": "923973159",
            "telephone_number": "760-249-5411",
            "fax_number": "760-249-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 HWY 2",
            "address_2": "STE C",
            "city": "WRIGHTWOOD",
            "state": "CA",
            "postal_code": "92397",
            "telephone_number": "760-249-5411",
            "fax_number": "760-249-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHON",
        "first_name": "SEUNG",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-02",
        "last_updated": "2013-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mario Albert Jauregui, D.C.
• Meaghan Martin Licensed Clinicial Social Worker Corporation
• Betty Omlor, LMFT
• Catherine Saldana, M.A.
• Steve Sexton, DPT
• Melissa K. Stratton, LMFT 135761
• Heather Williams, CADC - III

• General Practice Dentistry in Wrightwood, CA
• Providers in Wrightwood, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.