Samuel S Kwon - Flowery Branch DMD PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN012637 Issued in GA

Legal business name

SAMUEL S KWON - FLOWERY BRANCH DMD PC

Practice address

4009 Winder Hwy
Suite 200
Flowery Branch, GA 30542-6555

Phone

(678) 714-7575

Fax

(678) 714-7525

NPI assigned

Nov 23, 2015

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, DMD

Title

Owner

Phone

(678) 714-7575

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1448236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449014400000",
    "number": "1629442074",
    "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": "4009 WINDER HWY",
            "address_2": "SUITE 200",
            "city": "FLOWERY BRANCH",
            "state": "GA",
            "postal_code": "305426555",
            "telephone_number": "678-714-7575",
            "fax_number": "678-714-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL S KWON - FLOWERY BRANCH DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-23",
        "last_updated": "2015-12-02",
        "status": "A",
        "authorized_official_last_name": "KWON",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-714-7575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN012637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Wendy Anita Royal, PA
• Sonea Maria Russell, PTA
• Amanda Renee Salerno
• Anna Satterfield, M.S., OTR/L
• Justin Asling Sawyer, COTA
• Brittany Schimmelbusch, BC-HIS
• Troy Alan Schlenker, LDO
• Jacquelyn Sue Schneider, RN

• Pediatric Dentistry in Flowery Branch, GA
• Providers in Flowery Branch, 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 2, 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.