Min Chul Kwon, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12011206 Issued in IN

Practice address

6910 N Main St
Unit 6B
Granger, IN 46530-9681

Phone

(574) 247-2521

NPI assigned

Apr 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

State licenses

Practice roles

Locations

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

• Intercare Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Bangor, MI
  • NPI 1326058512
  Medicare reassignment NPD
• Intercare Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Eau Claire, MI
  • NPI 1336701119
  NPD

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1437112380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6910 N MAIN ST",
            "address_2": "UNIT 6B",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465309681",
            "telephone_number": "574-247-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 N MAIN ST",
            "address_2": "UNIT 6B",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465309681",
            "telephone_number": "574-247-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "MIN CHUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "17583",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amantha Kuhn
• Iryna Kulyk, MD
• Kumar Therapy Services, LLC
• Katelyn Kush, DPT
• Christine Kwan, PHARM.D.
• Labex LLC
• Elizabeth Laird, LCSW
• Latitudes, Inc
• Alexis Laughman
• Thomas Francis Lavelle Jr., M.D.

• General Practice Dentistry in Granger, IN
• Providers in Granger, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.