Individual provider Active NPI

John Hyun Namgoong, DDS

  • Dentist
  • El Segundo, CA
National Provider Identifier
1578299632
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12961768-9921 Issued in UT
Practice address
483 N Aviation Blvd BLDG 210
El Segundo, CA 90245-2808
Phone
(310) 653-6844
NPI assigned
Jul 29, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12961768-9921 UT Primary

Addresses

Primary practice location

483 N Aviation Blvd BLDG 210
El Segundo, CA 90245-2808

Mailing address

483 N Aviation Blvd BLDG 210
El Segundo, CA 90245-2808
Phone (310) 653-6844

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12961768-9921UTMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1578299632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 N AVIATION BLVD BLDG 210",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452808",
            "telephone_number": "310-653-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 N AVIATION BLVD BLDG 210",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452808",
            "telephone_number": "310-653-6844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMGOONG",
        "first_name": "JOHN",
        "middle_name": "HYUN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-29",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "12961768-9921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; 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.