Kelly J Hwang DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

License

61930 Issued in CA

Legal business name

KELLY J HWANG DDS INC

Practice address

11385 Poway Rd Ste 103
San Diego, CA 92128-5600

Phone

(858) 486-8611

Fax

(858) 486-1099

NPI assigned

Dec 6, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Kelly J Hwang, D.D.S.NPI 1790030633

Title

President

Phone

(858) 486-8611

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly J Hwang, D.D.S.

  • Dentist
  • Lake Elsinore, CA
  • NPI 1790030633
  NPD Authorized official
• Mina Habibian, D.M.D., PH.D.

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1427070515
  NPD (past)

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561593600000",
    "number": "1477068930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 POPPY RD",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920786905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11385 POWAY RD STE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921285600",
            "telephone_number": "858-486-8611",
            "fax_number": "858-486-1099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "141 N Main St",
            "address_purpose": "LOCATION",
            "city": "Lake Elsinore",
            "state": "CA",
            "postal_code": "925304118",
            "country_code": "US",
            "telephone_number": "951-245-5003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KELLY J HWANG DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-06",
        "last_updated": "2019-06-27",
        "status": "A",
        "authorized_official_last_name": "HWANG",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-486-8611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "61930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Joy Kellogg, FNP-C, RN, MSN
• Lorena Kellogg
• Marlyn Kellogg
• Shannon Marie Kellogg, MA
• Sopahn Kellogg
• Kelly Keane OD Professional Corporation
• Kelly L. Lange Psychology, a Professional Corporation
• Kelly S Keefe MD Inc
• Kyelunye Kelly-Adegbola
• Martha Kelly-Luken

• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.