Samuel S Kwon DMD PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN012637 Issued in GA

Legal business name

SAMUEL S KWON DMD PC

Practice address

3590 Braselton Hwy
Suite 201
Dacula, GA 30019-1117

Phone

(678) 714-7575

Fax

(678) 714-7525

NPI assigned

Mar 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Samuel S. Kwon, D.M.D.

Title

Dentist

Phone

(678) 714-7575

Specialties & licenses 1

Addresses

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Samuel S. Kwon,DMD-IV Center PC

  dba Kwon Pediatric Dentistry

  • Pediatric Dentistry
  • Dacula, GA
  • NPI 1538692314
  NPPES parent name

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449532800000",
    "number": "1457476608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3590 BRASELTON HWY",
            "address_2": "SUITE 201",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191117",
            "telephone_number": "678-714-7575",
            "fax_number": "678-714-7525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3590 BRASELTON HWY",
            "address_2": "SUITE 201",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191117",
            "telephone_number": "678-714-7575",
            "fax_number": "678-714-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL S KWON DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2015-12-08",
        "status": "A",
        "authorized_official_last_name": "KWON",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "678-714-7575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN012637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sacred Seasons Life Care
• Sage Rose Consulting
• Erika Victoria Salazar, RN, IBCLC
• Salient Healthcare Services, Inc
• Samantha Ball DO LLC (Ball Pediatrics)
• Samuel S. Kwon,DMD-IV Center PC (Kwon Pediatric Dentistry)
• Wanda Young Sanders, MED., EDS
• Kelly Sanderson
• Nhora A. Santiago-Gamboa, CSFA
• Catherine Jaques Santiago

• Pediatric Dentistry in Dacula, GA
• Providers in Dacula, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; 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.