Active NPI
Kee-Won Kwon, DDS
- Pediatric Dentistry
- Plano, TX
National Provider Identifier
1003902032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 28694
- Practice address
- 2301 Coit Rd
Suite a
Plano, TX 75075-3773 - Phone
- (262) 349-7509
- NPI assigned
- Oct 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 5636 | WI | |
| Pediatric Dentistry | 1223P0221X | 28694 | TX | Primary |
Addresses
Primary practice location
2301 Coit Rd
Suite a
Plano, TX 75075-3773
Mailing address
2301 Coit Rd
Suite a
Plano, TX 75075-3773
Phone (262) 349-7509
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120713000480 | WI | Order and Referring Only - Oral Surgery | 3072778240 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28694 | TX | MD | Pediatric Dentist |
| 5636 | WI | MD | Pediatric Dentist |
| 5363 | WI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383609600000",
"number": "1003902032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 COIT RD",
"address_2": "SUITE A",
"city": "PLANO",
"state": "TX",
"postal_code": "750753773",
"telephone_number": "262-349-7509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 COIT RD",
"address_2": "SUITE A",
"city": "PLANO",
"state": "TX",
"postal_code": "750753773",
"telephone_number": "262-349-7509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWON",
"first_name": "KEE-WON",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-05",
"last_updated": "2013-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "WI",
"license": "5636",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "28694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; 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.