Hyun Kyong Kwak, DMD
Individual provider Active NPI Pediatric Dentistry · Perry Hall, MD
NPI 1962094425 · NPPES record last updated Jan 9, 2024
Key facts
- NPI
- 1962094425
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Dentistry 1223P0221X
- License
- 17879 (MD)
- Practice address
- 5002 Honeygo Center Dr Ste 101
Perry Hall, MD 21128-8962 - Phone
- (410) 248-3384
- Fax
- (410) 248-3385
- NPI assigned
- Feb 5, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17879 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chesapeake Pediatric Dental Group Inc | Pediatric Dentistry | Current |
Accepting new patients |
| Chesapeake Pediatric Dental Group, Inc | Pediatric Dentistry | Current |
Accepting new patients |
| CPDG-DD, LLC | Pediatric Dentistry | Past |
Accepting new patients |
Locations
5009 Honeygo Center Dr
Ste 228
Perry Hall, MD 21128
Phone (410) 248-3384
5002 Honeygo Center Dr
Ste 101
Perry Hall, MD 21128
Phone (410) 248-3384
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 17879 | MD | Yes |
Addresses
Primary practice location
5002 Honeygo Center Dr Ste 101
Perry Hall, MD 21128-8962
Mailing address
5002 Honeygo Center Dr Ste 101
Perry Hall, MD 21128-8962
Other names
- Hannah Kwak
Other providers in Perry Hall, MD
- Patricia Kimeu
- Renee Klawunder
- Sammy Kosmas
- Sita Kottapalli
- Hakan Omer Koymen
- Kristin Laferty
- Nicole Lambert
- Katherine Anne Langrehr
- A'Jeenah Mikhael Latimer
- Sora Lee
All providers in Perry Hall, MD · Pediatric Dentistry in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.