NPIMap

Organization Active NPI

Sunset Dental Professional

  • Dentist
  • West Covina, CA
National Provider Identifier
1104125855
Registry record updated Mar 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
52627 Issued in CA
Legal business name
SUNSET DENTAL PROFESSIONAL
Practice address
1042 W West Covina Pkwy
West Covina, CA 91790-2810
Phone
(626) 960-2766
Fax
(626) 962-8216
NPI assigned
Mar 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2011

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

Authorized official

Name
Dr. Andrew Woosung Kwon, DDS
Title
Dentist
Phone
(626) 960-2766

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 52627 CA Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 54659 CA

Addresses

Primary practice location

1042 W West Covina Pkwy
West Covina, CA 91790-2810

Mailing address

1042 W West Covina Pkwy
West Covina, CA 91790-2810
Phone (626) 960-2766

National Provider Directory

National Provider Directory
Tax ID family
Sunset Dental Professional2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300665600000",
    "number": "1104125855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1042 W WEST COVINA PKWY",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902810",
            "telephone_number": "626-960-2766",
            "fax_number": "626-962-8216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1042 W WEST COVINA PKWY",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902810",
            "telephone_number": "626-960-2766",
            "fax_number": "626-962-8216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSET DENTAL PROFESSIONAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-21",
        "last_updated": "2011-03-21",
        "status": "A",
        "authorized_official_last_name": "KWON",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "WOOSUNG",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "626-960-2766",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "52627",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54659",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2011; 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.