Gi Tae Kwon, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11856 Issued in CT

Practice address

258 S Frontage Rd
New London, CT 06320-2641

Phone

(860) 437-3462

NPI assigned

Aug 8, 2017

Sex

Male

Sole proprietor

No

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 and National Provider Directory roles.

• New London Dental Care, LLC

  • General Practice Dentistry
  • New London, CT
  • NPI 1629364997
  NPD (past)

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

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502150400000",
    "number": "1649795964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4003 MAPLE TREE LN",
            "city": "EAST LYME",
            "state": "CT",
            "postal_code": "063331671",
            "telephone_number": "201-707-4661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 S FRONTAGE RD",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063202641",
            "telephone_number": "860-437-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "GI TAE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-08",
        "last_updated": "2017-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "11856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sutip Kunajukr, M.D.
• Molly A Kunka, LCSW
• Kimberly Anne Kurey, FNP
• Kathleen Kurowski, MD
• Abigail Kuziel, BS
• L&M Medical Group
• Lorraine E Labarre, LCSW
• Micaela Nicole Labonte
• Laboratory Medicine Consultants, LLC
• Kimberley Ann Labrie, RPH

• General Practice Dentistry in New London, CT
• Providers in New London, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2017; 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.