Active NPI
Cho Ryon Kwon
- Dentist
- Duluth, GA
National Provider Identifier
1881084309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN014890
- Practice address
- 1160 Old Peachtree Rd
Duluth, GA 30097-5125 - Phone
- (678) 473-7770
- NPI assigned
- Feb 4, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN014890 | GA | Primary |
Addresses
Primary practice location
1160 Old Peachtree Rd
Duluth, GA 30097-5125
Mailing address
3051 Hartright Bend CT
Duluth, GA 30096-9276
Phone (909) 809-7423
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160112003307 | GA | Order and Referring Only - Oral Surgery | 1850693540 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451433600000",
"number": "1881084309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3051 HARTRIGHT BEND CT",
"city": "DULUTH",
"state": "GA",
"postal_code": "300969276",
"telephone_number": "909-809-7423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1160 OLD PEACHTREE RD",
"city": "DULUTH",
"state": "GA",
"postal_code": "300975125",
"telephone_number": "678-473-7770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWON",
"first_name": "CHO RYON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-04",
"last_updated": "2015-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "DN014890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Duluth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; 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.