Individual provider Active NPI

Samuel Soo Ahn, D.C.

  • Chiropractor
  • Dallas, TX
National Provider Identifier
1447489984
Registry record updated Mar 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11211 Issued in TX
Practice address
2710 N Stemmons Fwy
Suite 101
Dallas, TX 75207-2210
Phone
(214) 905-4999
Fax
(214) 905-4999
NPI assigned
Jul 6, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11211 TX Primary

Addresses

Primary practice location

2710 N Stemmons Fwy
Suite 101
Dallas, TX 75207-2210

Mailing address

2710 N Stemmons Fwy
Suite 101
Dallas, TX 75207-2210
Phone (214) 905-4999

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
11211TXMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299110400000",
    "number": "1447489984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 N STEMMONS FWY",
            "address_2": "SUITE 101",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752072210",
            "telephone_number": "214-905-4999",
            "fax_number": "214-905-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 N STEMMONS FWY",
            "address_2": "SUITE 101",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752072210",
            "telephone_number": "214-905-4999",
            "fax_number": "214-905-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "SAMUEL",
        "middle_name": "SOO",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-06",
        "last_updated": "2011-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; 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.