Stephen Soonbeom Kwon, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

063774 Issued in NY

Practice address

2035 Lakeville Rd Ste 205
New Hyde Park, NY 11040-1661

Phone

(516) 437-1633

NPI assigned

Jul 15, 2020

Last updated

Jul 18, 2024By the provider in NPPES

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nassau-Queens Endodontics, P.C.

  • Endodontics
  • New Hyde Park, NY
  • NPI 1801921028
  NPD (past)

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1609484757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 DARTMOUTH DR",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117291005",
            "telephone_number": "516-240-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 LAKEVILLE RD STE 205",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401661",
            "telephone_number": "516-437-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "STEPHEN",
        "middle_name": "SOONBEOM",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-15",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "063774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jovita Kwan, NP
• Thomas Kwiatkowski
• Lisa Kwiecinski, CRNA
• Sophia H Kwo, M.D.
• Elena N. Kwon, M.D.
• Yeshin Kwon
• L&L Dental Associates, LLP
• L&L Drugs of Nassau,Inc (Drugs Plus)
• Allison Elizabeth La Rosa, LCSW
• Daniel La, MD

• Endodontics in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Endodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.