Tae Hyun Kwon, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

04034 Issued in NH

Practice address

819 Court St Unit a
Keene, NH 03431-1773

Phone

(603) 215-5800

NPI assigned

Aug 10, 2011

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

Enrolled in MA

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

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.

• Monadnock Perio & Implant Center

  • Periodontics
  • Keene, NH
  • NPI 1548949142
  NPD

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

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1760761563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 COURT ST UNIT A",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034311773",
            "telephone_number": "603-215-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 COURT ST UNIT A",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034311773",
            "telephone_number": "603-215-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "TAE HYUN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-10",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NH",
            "license": "04034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl A. Krupnick, PSY.D.
• Billy-Jo Kundel
• Carol H Kurimay, MS
• Jennifer Kwak
• Edward R Kwasniewski, D.C.
• Kristie N La Monica, PA
• Dylan Michael Labarge
• Melinda McCoy Labarge, B.S.
• Wanda Labrecque
• Kyle Labrie

• Periodontics in Keene, NH
• Providers in Keene, NH by specialty
• Periodontics in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; 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.