Active NPI
Jason Kwan, DDS
- Dentist
- Plainfield, NJ
National Provider Identifier
1952744005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22DI02563200
- Practice address
- 1024 Park Ave
Suite #1
Plainfield, NJ 07060-3026 - Phone
- (908) 668-5888
- NPI assigned
- Apr 8, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 22DI02563200 | NJ | Primary |
Addresses
Primary practice location
1024 Park Ave
Suite #1
Plainfield, NJ 07060-3026
Mailing address
1024 Park Ave
Suite #1
Plainfield, NJ 07060-3026
Phone (908) 668-5888
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0538558 | Medicaid | NJ |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02563200 | NJ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481846400000",
"number": "1952744005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1024 PARK AVE",
"address_2": "SUITE #1",
"city": "PLAINFIELD",
"state": "NJ",
"postal_code": "070603026",
"telephone_number": "908-668-5888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1024 PARK AVE",
"address_2": "SUITE #1",
"city": "PLAINFIELD",
"state": "NJ",
"postal_code": "070603026",
"telephone_number": "908-668-5888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWAN",
"first_name": "JASON",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-04-08",
"last_updated": "2016-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "22DI02563200",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0538558",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plainfield, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.