Individual provider Active NPI

Eric Son Kwon, DDS

  • General Practice Dentistry
  • Palo Alto, CA
National Provider Identifier
1689902363
Registry record updated Dec 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
56725 Issued in CA
Practice address
850 Middlefield Rd Ste 2
Palo Alto, CA 94301-2918
Phone
(650) 322-4750
Fax
(650) 322-0703
NPI assigned
Nov 18, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 56725 CA Primary

Addresses

Primary practice location

850 Middlefield Rd Ste 2
Palo Alto, CA 94301-2918

Mailing address

850 Middlefield Rd Ste 2
Palo Alto, CA 94301-2918
Phone (650) 322-4750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
56725CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1258502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1689902363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 MIDDLEFIELD RD STE 2",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012918",
            "telephone_number": "650-322-4750",
            "fax_number": "650-322-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 MIDDLEFIELD RD STE 2",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012918",
            "telephone_number": "650-322-4750",
            "fax_number": "650-322-0703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "ERIC",
        "middle_name": "SON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-18",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.