Individual provider Active NPI

Sukyoung Ahn, DDS

  • Dentist
  • Chico, CA
National Provider Identifier
1902936602
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
51226 Issued in CA
Practice address
111 Raley Blvd Ste 260
Chico, CA 95928-8351
Phone
(530) 342-0104
Fax
(530) 342-0104
NPI assigned
Mar 6, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 51226 CA Primary

Addresses

Primary practice location

111 Raley Blvd Ste 260
Chico, CA 95928-8351

Mailing address

111 Raley Blvd Ste 260
Chico, CA 95928-8351
Phone (530) 342-0104

Other practice location 1

5734 Canyon View Dr
Paradise, CA 95969-5503
Phone (530) 876-7254

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

LicenseStateTypeSpecialty
51226CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Suk Young Ahn DDS Inc Dentist PastSince Jul 24, 2022 Accepting new patients
N.Michelle Borg DDS, Inc Dentist PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1902936602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 RALEY BLVD STE 260",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959288351",
            "telephone_number": "530-342-0104",
            "fax_number": "530-342-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 RALEY BLVD STE 260",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959288351",
            "telephone_number": "530-342-0104",
            "fax_number": "530-342-0104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5734 Canyon View Dr",
            "address_purpose": "LOCATION",
            "city": "Paradise",
            "state": "CA",
            "postal_code": "959695503",
            "country_code": "US",
            "telephone_number": "530-876-7254",
            "fax_number": "530-876-7969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHN",
        "first_name": "SUKYOUNG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "51226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.