Active NPI
Sean T Ky, DDS
- General Practice Dentistry
- Pasadena, CA
National Provider Identifier
1821052861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 45481
- Practice address
- 3858 E Colorado Blvd
Pasadena, CA 91107-3940 - Phone
- (626) 795-4251
- Fax
- (626) 795-3562
- NPI assigned
- Apr 14, 2006
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 45481 | CA | Primary |
Addresses
Primary practice location
3858 E Colorado Blvd
Pasadena, CA 91107-3940
Mailing address
3858 E Colorado Blvd
Pasadena, CA 91107-3940
Phone (626) 795-4251
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1323676 | Other | CA | UNITED CONCORDIA INS |
| B45481 | Other | CA | HEALTHY FAMILIES |
| G93499 | Medicaid | CA |
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 |
|---|---|---|---|
| 45481 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349049600000",
"number": "1821052861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3858 E COLORADO BLVD",
"city": "PASADENA",
"state": "CA",
"postal_code": "911073940",
"telephone_number": "626-795-4251",
"fax_number": "626-795-3562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3858 E COLORADO BLVD",
"city": "PASADENA",
"state": "CA",
"postal_code": "911073940",
"telephone_number": "626-795-4251",
"fax_number": "626-795-3562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KY",
"first_name": "SEAN",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-14",
"last_updated": "2012-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "45481",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA INS",
"identifier": "1323676",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHY FAMILIES",
"identifier": "B45481",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G93499",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.