Active NPI
William Myung Kwon, DDS, MD
- Oral and Maxillofacial Surgery (Dentist)
- Westminster, CA
National Provider Identifier
1669956769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 105853
- Practice address
- 9010 Bolsa Ave
Westminster, CA 92683-5531 - Phone
- (929) 888-0397
- NPI assigned
- Sep 24, 2018
- Last updated
- Aug 4, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 105853 | CA | Primary |
Addresses
Primary practice location
9010 Bolsa Ave
Westminster, CA 92683-5531
Mailing address
21072 Spurney LN
Huntington Beach, CA 92646-7214
Phone (929) 888-0397
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210827002077 | CA | Order and Referring Only - Oral Surgery | 5890190995 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105853 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| W.M. Kwon Dental Inc | Oral and Maxillofacial Surgery | Current | Accepting new patients |
Locations
9010 Bolsa Ave
Westminster, CA 92683
Phone (714) 892-5710
Interoperability endpoints
- wkwon809258@direct.memorialcare.org
Organizations & group practices 1
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.
-
dba Do Dental Studio
- Dentist
- Westminster, CA
- NPI 1164268439
Oral and Maxillofacial Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691107200000",
"number": "1669956769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21072 SPURNEY LN",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926467214",
"telephone_number": "929-888-0397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9010 BOLSA AVE",
"city": "WESTMINSTER",
"state": "CA",
"postal_code": "926835531",
"telephone_number": "929-888-0397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWON",
"first_name": "WILLIAM",
"middle_name": "MYUNG",
"name_prefix": "Dr.",
"credential": "DDS, MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-09-24",
"last_updated": "2023-08-04",
"certification_date": "2023-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "CA",
"license": "105853",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Westminster, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.