Individual provider Active NPI

Seonha Park, DMD

  • Dentist
  • Seattle, WA
National Provider Identifier
1932516929
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE61289001 Issued in WA
Practice address
901 Boren Ave Ste 1500
Seattle, WA 98104-3543
Phone
(206) 323-3830
NPI assigned
Jul 22, 2014
Last updated
Apr 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE61289001 WA Primary
General Practice Dentistry 1223G0001X 059007 NY

Addresses

Primary practice location

901 Boren Ave Ste 1500
Seattle, WA 98104-3543

Mailing address

901 Boren Ave Ste 1500
Seattle, WA 98104-3543
Phone (617) 958-1986

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150629000407 MA Order and Referring Only - DentistPractitioner - Dentist 8224340666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE61289001WAMDDentist
059007NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sukhdev Singh, DMD, PS General Practice CurrentSince Apr 20, 2025 Accepting new patients

Locations

901 Boren Ave
Ste 1500
Seattle, WA 98104
Phone (206) 323-3830

Organizations & group practices 1

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": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1932516929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 BOREN AVE STE 1500",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043543",
            "telephone_number": "617-958-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 BOREN AVE STE 1500",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043543",
            "telephone_number": "206-323-3830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SEONHA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61289001",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "059007",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.