Sung M. Ahn, D.D.S., Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SUNG M. AHN, D.D.S., INC.

Practice address

16922 Main St Ste F
Hesperia, CA 92345-6011

Phone

(760) 244-4844

Fax

(760) 244-5002

NPI assigned

Jun 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Sung Min Ahn, D.D.S.NPI 1326067489

Title

Ceo

Phone

(760) 244-4844

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sung Min Ahn, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Hesperia, CA
  • NPI 1326067489
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625529600000",
    "number": "1801093034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16922 MAIN ST STE F",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923456011",
            "telephone_number": "760-244-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16922 MAIN ST STE F",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923456011",
            "telephone_number": "760-244-4844",
            "fax_number": "760-244-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNG M. AHN, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-29",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A",
        "authorized_official_last_name": "AHN",
        "authorized_official_first_name": "SUNG MIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-244-4844",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "52706",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G93705-01",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL OF CALIFORNI",
            "identifier": "52706CA",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guilbert T Stroschein, D.D.S.,M.D.
• Piala Styadi, PHARM. D
• Tina Marie Sudduth, REGISTERED NURSE
• Summit Leadership Academy - High Desert
• Desiree Sundeen
• Stephen John Svastits, D.C.,C.C.S.P.,I.D.E.
• Makinzie Sweet
• Andrew Tadang, PHARMD
• Tetris Ylizah Apostol Tan, MD
• Sophia Tannenberg

• Dental Clinic/Center in Hesperia, CA
• Providers in Hesperia, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.