Individual provider Active NPI

James Ikjae Kwon, D.D.S.

  • General Practice Dentistry
  • Palatine, IL
National Provider Identifier
1023008174
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019026324 Issued in IL
Practice address
177 W Northwest Hwy
Palatine, IL 60067-3550
Phone
(847) 991-0903
Fax
(847) 991-0832
NPI assigned
Oct 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019026324 IL Primary

Addresses

Primary practice location

177 W Northwest Hwy
Palatine, IL 60067-3550

Mailing address

177 W Northwest Hwy
Palatine, IL 60067-3550
Phone (847) 991-0903

Other identifiers 1

IdentifierTypeStateIssuer
019026324MedicaidIL

Other names 1

  • Dr. Ik-Jae Kwon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019026324ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kwon Dental Care, P.C. Current Accepting new patients

Locations

177 W Northwest Hwy
Palatine, IL 60067
Phone (847) 991-0903

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1023008174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 W NORTHWEST HWY",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600673550",
            "telephone_number": "847-991-0903",
            "fax_number": "847-991-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 W NORTHWEST HWY",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600673550",
            "telephone_number": "847-991-0903",
            "fax_number": "847-991-0832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "JAMES",
        "middle_name": "IKJAE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019026324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019026324",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IK-JAE",
            "last_name": "KWON",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Palatine, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.