NPIMap

Individual provider Active NPI

Hojoong Ryu, DDS

  • General Practice Dentistry
  • Grand Prairie, TX
National Provider Identifier
1710327614
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30446 Issued in TX
Practice address
1017 Fort Worth St Ste 100
Grand Prairie, TX 75050-5404
Phone
(469) 827-7554
NPI assigned
Jun 25, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE60399986 WA
General Practice Dentistry 1223G0001X DD3988 NM
General Practice Dentistry 1223G0001X 30446 TX Primary

Addresses

Primary practice location

1017 Fort Worth St Ste 100
Grand Prairie, TX 75050-5404

Mailing address

1017 Fort Worth St Ste 100
Grand Prairie, TX 75050-5404
Phone (469) 827-7554

Other names 1

  • David Ryu Professional 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
DD3988NMMDGeneral Practice Dentistry
DE60399986WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
SJ Kang Dental One, PLLC General Practice Current Accepting new patients
Family Group Dental Inc Past Accepting new patients
Hojoong Ryu DDS PLLC Past Accepting new patients

Locations

1017 Fort Worth St
Ste 100
Grand Prairie, TX 75050
Phone (214) 412-2595

Organizations & group practices 3

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": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1710327614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 FORT WORTH ST STE 100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750505404",
            "telephone_number": "469-827-7554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 FORT WORTH ST STE 100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750505404",
            "telephone_number": "469-827-7554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYU",
        "first_name": "HOJOONG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-25",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60399986",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD3988",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "30446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "RYU",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; 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.