Hee Joon Kwak, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

051024-1 Issued in NY

Practice address

638 E 169TH St
Bronx, NY 10456-2623

Phone

(718) 991-8668

Fax

(718) 466-0782

NPI assigned

Oct 20, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kwak Dental Management, PLLC

  • General Practice Dentistry
  • Bronx, NY
  • NPI 1417129974
  NPD (past) Authorized official

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1548259591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2321 144TH ST",
            "address_2": "2ND FLOOR",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113573433",
            "telephone_number": "718-791-4066",
            "fax_number": "718-466-0782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 E 169TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104562623",
            "telephone_number": "718-991-8668",
            "fax_number": "718-466-0782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAK",
        "first_name": "HEE JOON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "051024-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02521520",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valerie Kuzmin
• Kwadwo Boakye Physician, PC
• Forster Kwafo, AGNP
• Kwak Dental Management, PLLC
• Albert Kwak
• Iris Herin Kwak, MD
• Taehee Kwak, MD
• Oscar Kwan, PHARMD
• Peter C Kwan, M.D.
• Maureen Mary Yunkap Kwankam, M.D., MPH

• Dentist in Bronx, NY
• Providers in Bronx, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.