Active NPI
Hyemin Sohn, DDS
- Endodontics
- San Mateo, CA
National Provider Identifier
1770269748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 108857
- Practice address
- 100 South Ellsworth Ave 801
San Mateo, CA 94401 - Phone
- (650) 344-0299
- NPI assigned
- Jun 26, 2023
- Last updated
- Jun 26, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 108857 | CA | Primary |
Addresses
Primary practice location
100 South Ellsworth Ave 801
San Mateo, CA 94401
Mailing address
6432 Shayne Dr
Huntington Beach, CA 92647
Phone (714) 702-0463
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 |
|---|---|---|---|
| 108857 | CA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1770269748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6432 SHAYNE DR",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "92647",
"telephone_number": "714-702-0463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 SOUTH ELLSWORTH AVE 801",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "94401",
"telephone_number": "650-344-0299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOHN",
"first_name": "HYEMIN",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-26",
"last_updated": "2023-06-26",
"certification_date": "2023-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CA",
"license": "108857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.