Individual provider Active NPI

Hodong Kwon, D.D.S

  • Dentist
  • Amherst, NY
National Provider Identifier
1215348784
Registry record updated May 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
29824 Issued in TX
Practice address
4 Keph Dr Apt 6
Amherst, NY 14228-3255
Phone
(716) 235-0280
NPI assigned
May 18, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 29824 TX Primary

Addresses

Primary practice location

4 Keph Dr Apt 6
Amherst, NY 14228-3255

Mailing address

4 Keph Dr Apt 6
Amherst, NY 14228-3255
Phone (716) 235-0280

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
29824TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1400371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400371200000",
    "number": "1215348784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 KEPH DR APT 6",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142283255",
            "telephone_number": "716-235-0280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 KEPH DR APT 6",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142283255",
            "telephone_number": "716-235-0280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "HODONG",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-18",
        "last_updated": "2014-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "29824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2014; 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.