Jenny Kwon

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019028247 Issued in IL

Practice address

2537 W North Ave
Melrose Park, IL 60160-1121

Phone

(708) 345-6400

NPI assigned

Jun 8, 2010

Last updated

Jun 8, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dental Experts, LLC

  • General Practice Dentistry
  • Melrose Park, IL
  • NPI 1780855775
  NPD (past)

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

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275955200000",
    "number": "1689994055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 N MCCLURG CT",
            "address_2": "UNIT 4106",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115359",
            "telephone_number": "312-955-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2537 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601121",
            "telephone_number": "708-345-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "JENNY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-08",
        "last_updated": "2010-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell Kruckenberg, MED, LPC
• Kristen B Kruse, PT
• Sibil Rose Kuruvilla, LCSW
• Glenn Alan Kushner, MD
• Teneshia Kuykendoll, BA
• Michelle Lagrimas, B.A.
• Santosh Lal, MD
• Stephanie Lamonica, PHARMD
• John R Lang, OD
• Laura E Loya-Frank M D S C

• General Practice Dentistry in Melrose Park, IL
• Providers in Melrose Park, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2010; 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.