Individual provider Active NPI

Seeun Mok, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Victorville, CA
National Provider Identifier
1639695950
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
101972 Issued in CA
Practice address
12640 Hesperia Rd Ste F
Victorville, CA 92395-7753
Phone
(443) 285-3992
NPI assigned
Aug 17, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 101972 CA Primary

Addresses

Primary practice location

12640 Hesperia Rd Ste F
Victorville, CA 92395-7753

Mailing address

1111 Watervista Ter
Pooler, GA 31322-5500
Phone (443) 285-3992

Other practice location 1

2629 E Gage Ave
Huntington Park, CA 90255-4121
Phone (323) 588-8252

Other practice location 2

3300 Odd Fellows Rd
Unit 11251
Lynchburg, VA 24506
Phone (443) 285-3992

Other names 1

  • Dr. Seeun Sarah Mok Other name

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
101972CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Diana Zinberg DDS, Inc Dentist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1639695950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 WATERVISTA TER",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313225500",
            "telephone_number": "443-285-3992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12640 HESPERIA RD STE F",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957753",
            "telephone_number": "443-285-3992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2629 E Gage Ave",
            "address_purpose": "LOCATION",
            "city": "Huntington Park",
            "state": "CA",
            "postal_code": "902554121",
            "country_code": "US",
            "telephone_number": "323-588-8252",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3300 Odd Fellows Rd",
            "address_2": "Unit 11251",
            "address_purpose": "LOCATION",
            "city": "Lynchburg",
            "state": "VA",
            "postal_code": "24506",
            "country_code": "US",
            "telephone_number": "443-285-3992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOK",
        "first_name": "SEEUN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-17",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "101972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SEEUN",
            "last_name": "MOK",
            "middle_name": "SARAH",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.