Laurel Yoonjung Kwon

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

108997 Issued in CA

Practice address

7369 Day Creek Blvd Ste F-103
Rancho Cucamonga, CA 91739-8020

Phone

(909) 646-7902

NPI assigned

Sep 5, 2023

Last updated

Sep 5, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ghazal and Hsieh Dental Corporation

  dba Winery Estate Dental Group

  • General Practice Dentistry
  • Rancho Cucamonga, CA
  • NPI 1629173547
  NPD (past)

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1356127583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7828 DAY CREEK BLVD APT 632",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917398576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7369 DAY CREEK BLVD STE F-103",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917398020",
            "telephone_number": "909-646-7902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "LAUREL",
        "middle_name": "YOONJUNG",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-05",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "108997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Kuznitz, DPT
• Nancy Suk-Ying Kwan, O.D.
• Gideon Puiyuen Kwok, DO
• Gigi Yin CHI Kwok, M.S., R.D.
• Ricky Kwok, P.T.
• Jennie Kwun
• Priscilla Kyei
• Wade A Kyle, D.MIN,M-RAS
• L. Khalil Dental Corporation
• L. Khalil Dental Corporation

• General Practice Dentistry in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, 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 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.