Kenneth Andrew Tjon, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

41875 Issued in CA

Practice address

27221 La Paz Rd Ste G
Laguna Niguel, CA 92677-3630

Phone

(949) 831-1402

Fax

(949) 831-1872

NPI assigned

Sep 29, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1191024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191024000000",
    "number": "1346437753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27221 LA PAZ RD STE G",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926773630",
            "telephone_number": "949-831-1402",
            "fax_number": "949-831-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27221 LA PAZ RD STE G",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926773630",
            "telephone_number": "949-831-1402",
            "fax_number": "949-831-1872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TJON",
        "first_name": "KENNETH",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-29",
        "last_updated": "2007-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "41875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Laguna Niguel, CA
• Providers in Laguna Niguel, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.

Verify at the official NPI Registry.