Individual provider Active NPI

Seokwon Kwon, D.D.S.

  • Dentist
  • Corona, CA
National Provider Identifier
1811440258
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
108713 Issued in CA
Practice address
2083 Compton Ave Ste 204
Corona, CA 92881-3416
Phone
(951) 406-6392
NPI assigned
Aug 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1857557 MA
Dentist 122300000X 062458 NY
Dentist 122300000X 108713 CA Primary
Dentist 122300000X 012252 CT
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2083 Compton Ave Ste 204
Corona, CA 92881-3416

Mailing address

13133 Harbor Blvd
Garden Grove, CA 92843-1717
Phone (145) 378-7707

Other practice location 1

31646 Dunlap Blvd
Yucaipa, CA 92399-1689
Phone (909) 794-4909

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
012252CTMDDentist
DN1857557MAMDDentist
062458NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Le Patrick Kha DMD Professional Corp PastSince Oct 15, 2023 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1811440258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13133 HARBOR BLVD",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431717",
            "telephone_number": "145-378-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2083 COMPTON AVE STE 204",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928813416",
            "telephone_number": "951-406-6392"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31646 Dunlap Blvd",
            "address_purpose": "LOCATION",
            "city": "Yucaipa",
            "state": "CA",
            "postal_code": "923991689",
            "country_code": "US",
            "telephone_number": "909-794-4909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWON",
        "first_name": "SEOKWON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-02",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1857557",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "062458",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108713",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "012252",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; 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.