Active NPI
Sunkyo Seo
- Dentist
- Garden Grove, CA
National Provider Identifier
1497278105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 108245
- Practice address
- 10055 Garden Grove Blvd Unit a
Garden Grove, CA 92844-1600 - Phone
- (714) 638-4042
- NPI assigned
- Jul 25, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 108245 | CA | Primary |
Addresses
Primary practice location
10055 Garden Grove Blvd Unit a
Garden Grove, CA 92844-1600
Mailing address
10055 Garden Grove Blvd Unit a
Garden Grove, CA 92844-1600
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
| License | State | Type | Specialty |
|---|---|---|---|
| 108245 | CA | MD | Dentist |
Interoperability endpoints
- seo.sunkyo.p1@direct.gracehealthmi.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708646400000",
"number": "1497278105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10055 GARDEN GROVE BLVD UNIT A",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928441600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10055 GARDEN GROVE BLVD UNIT A",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928441600",
"telephone_number": "714-638-4042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEO",
"first_name": "SUNKYO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-07-25",
"last_updated": "2024-02-23",
"certification_date": "2024-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "108245",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.