Individual provider Active NPI

Steven Seungkyun Ko, DMD

  • Pediatric Dentistry
  • Sunnyvale, CA
National Provider Identifier
1720468275
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DDS101487 Issued in CA
Practice address
877 W Fremont Ave Ste C3
Sunnyvale, CA 94087-2319
Phone
(669) 777-3215
Fax
(669) 777-3214
NPI assigned
May 30, 2015
Last updated
Sep 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DDS101487 CA Primary

Addresses

Primary practice location

877 W Fremont Ave Ste C3
Sunnyvale, CA 94087-2319

Mailing address

74 Barnes CT Apt 200
Stanford, CA 94305-7105
Phone (484) 347-3896

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
DDS101487CAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jacobson Dental Corp Pediatric Dentistry Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sko251157@direct-ucsfmedicalcenter.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1432944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1720468275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 BARNES CT APT 200",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943057105",
            "telephone_number": "484-347-3896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 W FREMONT AVE STE C3",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940872319",
            "telephone_number": "669-777-3215",
            "fax_number": "669-777-3214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "STEVEN",
        "middle_name": "SEUNGKYUN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-30",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "DDS101487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.

Verify at the official NPI Registry.