Jeffrey Marc Hwang, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

58059 Issued in CA

Practice address

11092 Anderson Street
Llu School of Dentistry
Loma Linda, CA 92350-0001

Phone

(909) 558-4613

Fax

(909) 558-4192

NPI assigned

Mar 4, 2009

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

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1236124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236124800000",
    "number": "1689814535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11092 ANDERSON STREET",
            "address_2": "LLU SCHOOL OF DENTISTRY",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923500001",
            "telephone_number": "909-558-4613",
            "fax_number": "909-558-4192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11092 ANDERSON STREET",
            "address_2": "LLU SCHOOL OF DENTISTRY",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923500001",
            "telephone_number": "909-558-4613",
            "fax_number": "909-558-4192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HWANG",
        "first_name": "JEFFREY",
        "middle_name": "MARC",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-04",
        "last_updated": "2009-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "58059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "58059",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vu Quoc Huynh, DMD
• Anthony Daniel Hwang, PH.D.
• Brian Hwang
• Frank Sun Wook Hwang, MD
• Jason Soonho Hwang, M.D.
• Nicole Mina Hwang, MPH
• Stephanie Hwang, MD
• Shadman Hyder, MD
• Christine Hyun, M.D.
• Charisma Abigail Dancel Ibalio, MD

• Dentist in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; 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.

Verify at the official NPI Registry.