Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

SE Jin Ahn, MD

Individual provider Diagnostic Radiology Physician · NPI 1083020820

SE Jin Ahn, MD is a Diagnostic Radiology in Dallas, Texas. Qualified in 2008, 18 years ago. Practices with Sutter Valley Medical Foundation, a 2,464-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in California, Ohio, Texas and Washington.

Years since qualifying
18
Licensed in
CA, OH, TX, WA
In the registry since
2014
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2825 Oak Lawn Ave Unit 192749
Dallas, TX 75219-4688
Phone: (510) 683-9500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 757 Westwood Plz Ste 1638, Los Angeles, CA 90095-5201 — (310) 267-8796
  • 1245 16th St Ste 105, Santa Monica, CA 90404-1239 — (310) 301-6800

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence MD61036239 (WA)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence A159414 (CA)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 35C.003922 (OH)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence T7407 (TX)

Record details

NPI number1083020820
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedJuly 1, 2014
Last updated in NPPESApril 3, 2026
Certification dateApril 3, 2026
Mailing address2825 Oak Lawn Ave Unit 192749, Dallas, TX 75219-4688

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Sutter Valley Medical Foundation — 2464 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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