Hyunseon DO, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

109725 Issued in CA

Practice address

24658 University Ave
Loma Linda, CA 92354-2743

Phone

(909) 708-6938

NPI assigned

Dec 11, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1972370765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24658 UNIVERSITY AVE",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542743",
            "telephone_number": "909-708-6938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24658 UNIVERSITY AVE",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542743",
            "telephone_number": "909-708-6938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "HYUNSEON",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-11",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "109725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Kiley Dixon, MD
• Jedediah Dixon, MD
• Alan DO Vale Bravo, PT
• Catherine Lai DO, MD
• Hieu Duc DO, M.D
• Peter Bao DO, D.D.S.
• Ashley Thy Doan
• Berneithia Dobbs
• Florin Ionel Dobrea, M.P.T.
• Daniel A Dobroskay, MD

• General Practice Dentistry in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.