Suzin Um, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

64383 Issued in CA

Practice address

26700 Towne Centre Dr Ste 280
Foothill Ranch, CA 92610-2844

Phone

(949) 203-3177

NPI assigned

Jul 11, 2011

Sex

Female

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

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.

Opted out of Medicare

Yes, effective Jul 24, 2015 through Jul 24, 2027

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 and National Provider Directory roles.

• Suzin Um DDS, Inc

  dba Lake Forest Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Foothill Ranch, CA
  • NPI 1386203016
  NPD (past) Authorized official
• Song Dental Group, Inc.

  dba Song Oral Surgery

  • Oral and Maxillofacial Surgery Clinic/Center
  • San Francisco, CA
  • NPI 1649599267
  NPD (past)

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583539200000",
    "number": "1548558646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26700 TOWNE CENTRE DR STE 280",
            "city": "FOOTHILL RANCH",
            "state": "CA",
            "postal_code": "926102844",
            "telephone_number": "949-203-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26700 TOWNE CENTRE DR STE 280",
            "city": "FOOTHILL RANCH",
            "state": "CA",
            "postal_code": "926102844",
            "telephone_number": "949-203-3177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-920-5993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UM",
        "first_name": "SUZIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2020-03-07",
        "certification_date": "2020-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "64383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Swartz
• Brian Tan
• Charlene Tong, DDS
• Trojan Medical Center
• Paul H Turek, D.C.
• Karen Uyod
• Ryan Vasquez, PHARMD
• Leonard Stephen Vaughan, DDS, MD
• Verio Healthcare, Inc
• Lauren Elizabeth Victor, PT, DPT

• Oral and Maxillofacial Surgery (Dentist) in Foothill Ranch, CA
• Providers in Foothill Ranch, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2020; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.