SUNG MIN AHN, D.D.S. — NPI 1326067489 (Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) in HESPERIA, CA)

CMS-1500 Box 24J / 33a • NPI

1326067489

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

1223S0112X (CMS 19)

Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)

Box 32 Service Location & ZIP+4

16922 MAIN ST STE F, HESPERIA, CA, 92345-6011

✓ 9-Digit EDI 837 ZIP+4 (92345-6011)

Practice Phone & Referral Fax

(760) 244-4844

Fax: (760) 244-5002

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1326067489 (SUNG MIN AHN, D.D.S.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1326067489` (NPI-1 Individual Practitioner)
Provider / Legal Name	SUNG MIN AHN, D.D.S.
Plain-English Specialty	Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) NUCC Code: `1223S0112X` (Dentist, Oral and Maxillofacial Surgery)
Certifying / Licensing Body	American Dental Association (ADA) / State Board of Dental Examiners
Practice Location Address	16922 MAIN ST STE F, HESPERIA, CA, 92345-6011
Practice Telephone / Fax	Tel: (760) 244-4844 \| Fax: (760) 244-5002
Administrative Mailing Address	16922 MAIN ST STE F, HESPERIA, CA, 92345-6011
Enumeration & Last Sync	Enumerated: 2006-07-19 \| CMS Record Updated: 2021-07-06

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

16922 MAIN ST STE F, HESPERIA, CA, 92345-6011

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Plain-English Taxonomy & CMS Crosswalk (1223S0112X)

What Does Taxonomy Code 1223S0112X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 1223S0112X translates to:
"Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 19 (Oral Surgery (Dentist only))
Certifying / Accrediting Authority: American Dental Association (ADA) / State Board of Dental Examiners
Clinical Scope: Routine 6-month dental checkups, toothache, dental abscess, bleeding gums (periodontitis), or wisdom tooth extraction.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (SUNG MIN AHN, D.D.S.)

Typical CPT / Diagnostic Procedures:

Comprehensive Oral Evaluation, Digital Dental Radiographs & Prophylaxis
Restorative Composite Fillings, Crowns, Endodontic Root Canal & Extractions

Common Therapeutic Classes:

Amoxicillin, Metronidazole & Clindamycin (Odontogenic Infections)
Chlorhexidine Gluconate 0.12% Oral Rinse & High-Fluoride Varnish

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`1223G0001X` — Dentist, General Practice Plain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)	State: CA \| License: `52706` \| Primary: Secondary
`1223S0112X` — Dentist, Oral and Maxillofacial Surgery Plain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)	State: CA \| License: `52706` \| Primary: Yes (Primary)

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SUNG MIN AHN, D.D.S. (NPI #1326067489)