Active NPI
Paul Byun
- Orthodontics and Dentofacial Orthopedics Dentistry
- Casselberry, FL
National Provider Identifier
1740842764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DN22141
- Practice address
- 879 State Road 436
Casselberry, FL 32707-5360 - Phone
- (407) 767-7600
- NPI assigned
- Jun 29, 2019
- Last updated
- Jun 29, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN22141 | FL | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DN22141 | FL | Primary |
Addresses
Primary practice location
879 State Road 436
Casselberry, FL 32707-5360
Mailing address
600 Technology Park Ste 101
Lake Mary, FL 32746-7122
Phone (407) 543-8509
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 |
|---|---|---|---|
| DN22141 | FL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561766400000",
"number": "1740842764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 TECHNOLOGY PARK STE 101",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327467122",
"telephone_number": "407-543-8509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "879 STATE ROAD 436",
"city": "CASSELBERRY",
"state": "FL",
"postal_code": "327075360",
"telephone_number": "407-767-7600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BYUN",
"first_name": "PAUL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-29",
"last_updated": "2019-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN22141",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "FL",
"license": "DN22141",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Casselberry, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.