Magicland Pediatric Dental LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

MAGICLAND PEDIATRIC DENTAL LLC

Practice address

1141 Wolcott St
Waterbury, CT 06705-1318

Phone

(860) 282-0630

NPI assigned

Nov 9, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Chia Hui Jenny Kwon, DDS

Title

Member

Phone

(917) 453-4055

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740528000000",
    "number": "1033622246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 MAIN ST",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061082294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 WOLCOTT ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067051318",
            "telephone_number": "860-282-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGICLAND PEDIATRIC DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-09",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A",
        "authorized_official_last_name": "KWON",
        "authorized_official_first_name": "CHIA HUI",
        "authorized_official_middle_name": "JENNY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "917-453-4055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008004605",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sowmya Madireddy
• Bobbie Cheri Maebry
• Christine Maffeo-Anton, MD
• Paula Magalhaes Coelho, RDH
• Stephanie L Maggi, BCBA
• Winston Balot Magno, M.D.
• Roya Mahaba
• Jennie Leonard Maher, OD
• Kara L Maher
• Rex L Mahnensmith, M.D.

• Pediatric Dentistry in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Pediatric Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.