Organization Active NPI

Justin J Kwon DDS, P.C.

Doing business as Green Dental

  • General Practice Dentistry
  • Aurora, CO
National Provider Identifier
1366801953
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9372 Issued in CO
Legal business name
JUSTIN J KWON DDS, P.C.
Doing business as
Green Dental
Practice address
10700 E Bethany Dr Ste 210
Aurora, CO 80014-2680
Phone
(303) 745-8828
NPI assigned
Feb 11, 2016
Last updated
Feb 11, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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

Authorized official

Name
Justin KwonNPI 1982745634
Title
President
Phone
(720) 340-0348

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 9372 CO Primary

Addresses

Primary practice location

10700 E Bethany Dr Ste 210
Aurora, CO 80014-2680

Mailing address

10700 E Bethany Dr Ste 210
Aurora, CO 80014-2680
Phone (303) 745-8828

Other names 1

  • Green Dental Doing business as

National Provider Directory

National Provider Directory

Locations

10700 E Bethany Dr
Ste 210
Aurora, CO 80014
Phone (303) 745-8828

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455148800000",
    "number": "1366801953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 E BETHANY DR STE 210",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142680",
            "telephone_number": "303-745-8828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 E BETHANY DR STE 210",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142680",
            "telephone_number": "303-745-8828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN J KWON DDS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-11",
        "last_updated": "2016-02-11",
        "status": "A",
        "authorized_official_last_name": "KWON",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "720-340-0348"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "9372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Green Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2016; 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.