Active NPI
Stephen K Kwan, DDS
- Periodontics
- Santa Monica, CA
National Provider Identifier
1104016526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 27446
- Practice address
- 1304 15TH Street
Suite 308
Santa Monica, CA 90404 - Phone
- (310) 393-9706
- Fax
- (310) 899-1828
- NPI assigned
- Aug 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 27446 | CA | Primary |
Addresses
Primary practice location
1304 15TH Street
Suite 308
Santa Monica, CA 90404
Mailing address
1304 15TH Street
Suite 308
Santa Monica, CA 90404
Phone (310) 393-9706
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185926400000",
"number": "1104016526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1304 15TH STREET",
"address_2": "SUITE 308",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "90404",
"telephone_number": "310-393-9706",
"fax_number": "310-899-1828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1304 15TH STREET",
"address_2": "SUITE 308",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "90404",
"telephone_number": "310-393-9706",
"fax_number": "310-899-1828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWAN",
"first_name": "STEPHEN",
"middle_name": "K",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-01",
"last_updated": "2007-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "27446",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.