Soo Yeon Kwon, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS100159 Issued in CA

Practice address

5247 Beach Blvd
Buena Park, CA 90621-1248

Phone

(714) 224-4673

NPI assigned

May 13, 2016

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

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": "1463097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463097600000",
    "number": "1427404979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 STREAMWOOD",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926201933",
            "telephone_number": "269-267-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5247 BEACH BLVD",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906211248",
            "telephone_number": "714-224-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "SOO YEON",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-13",
        "last_updated": "2016-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS100159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Vierregger (Metamorphosis Medical Center)
• Sunny Kumar
• Junggyu Kwak
• Hannah Kwon Lee
• Joy Jehee Kwon
• Yurie Kwon
• Kyb Trading, Inc.
• Robert A Lafont, O.D.
• Khanh Minh Lam, O.M.D., L.AC.
• Janice Lampa

• General Practice Dentistry in Buena Park, CA
• Providers in Buena Park, 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 May 13, 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.