SE Eun Ahn, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

105263 Issued in CA

Practice address

1647 Admiral Taussig Blvd Ste 241
Norfolk, VA 23511-2803

Phone

(757) 953-8635

NPI assigned

Aug 14, 2020

Last updated

Aug 14, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Adel Ahn Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1861003576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 HARMON ST APT 101",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235184112",
            "telephone_number": "510-926-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1647 ADMIRAL TAUSSIG BLVD STE 241",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235112803",
            "telephone_number": "757-953-8635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "SE EUN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-14",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "105263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADEL",
            "last_name": "AHN",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• General Practice Dentistry in Norfolk, VA
• Providers in Norfolk, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; 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.