Active NPI
Soomin Hong, D.D.S, M.S.D.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Coppell, TX
National Provider Identifier
1629132303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 34723
- Practice address
- 620 N Coppell Rd Apt 3206
Coppell, TX 75019-2053 - Phone
- (415) 690-0611
- NPI assigned
- Dec 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DEN-8825 | CO | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 102080 | CA | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 34723 | TX | Primary |
Addresses
Primary practice location
620 N Coppell Rd Apt 3206
Coppell, TX 75019-2053
Mailing address
620 N Coppell Rd Apt 3206
Coppell, TX 75019-2053
Phone (415) 690-0611
Other practice location 1
1005 N Collins St Ste 100
Arlington, TX 76011-6131
Phone (682) 227-6710
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 71001549 | Medicaid | CO |
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
| License | State | Type | Specialty |
|---|---|---|---|
| DEN-8825 | CO | MD | General Practice Dentistry |
| 102080 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 34723 | TX | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568332800000",
"number": "1629132303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 N COPPELL RD APT 3206",
"city": "COPPELL",
"state": "TX",
"postal_code": "750192053",
"telephone_number": "415-690-0611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 N COPPELL RD APT 3206",
"city": "COPPELL",
"state": "TX",
"postal_code": "750192053",
"telephone_number": "415-690-0611"
}
],
"practiceLocations": [
{
"address_1": "1005 N Collins St Ste 100",
"address_purpose": "LOCATION",
"city": "Arlington",
"state": "TX",
"postal_code": "760116131",
"country_code": "US",
"telephone_number": "682-227-6710",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HONG",
"first_name": "SOOMIN",
"name_prefix": "Dr.",
"credential": "D.D.S, M.S.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-20",
"last_updated": "2019-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "DEN-8825",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "102080",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "TX",
"license": "34723",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "71001549",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coppell, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.