Individual provider Active NPI

Ke John Kweun, DDS

  • General Practice Dentistry
  • Cazenovia, NY
National Provider Identifier
1912312505
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
057969 Issued in NY
Practice address
4 Chenango St
Cazenovia, NY 13035-1400
Phone
(315) 655-5885
NPI assigned
Jun 23, 2014
Last updated
Mar 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 057969 NY Primary

Addresses

Primary practice location

4 Chenango St
Cazenovia, NY 13035-1400

Mailing address

4 Chenango St
Cazenovia, NY 13035-1400
Phone (315) 655-5885

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
057969NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Cazenovia Creekside Dental, PLLC General Practice CurrentSince Mar 28, 2021 Accepting new patients
Sunny Dental Fayetteville General Practice Current Accepting new patients
Vikas Goel, DMD PLLC General Practice Past Accepting new patients

Locations

4 Chenango St
Cazenovia, NY 13035
Phone (315) 655-5885

2521 Vestal Pkwy W
Vestal, NY 13850
Phone (607) 754-2217

Organizations & group practices 3

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": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1912312505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CHENANGO ST",
            "city": "CAZENOVIA",
            "state": "NY",
            "postal_code": "130351400",
            "telephone_number": "315-655-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CHENANGO ST",
            "city": "CAZENOVIA",
            "state": "NY",
            "postal_code": "130351400",
            "telephone_number": "315-655-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWEUN",
        "first_name": "KE",
        "middle_name": "JOHN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-23",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "057969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cazenovia, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.