Oh Jae Kwon, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

46484 Issued in CA

Practice address

9939 Magnolia Ave
Riverside, CA 92503-3528

Phone

(951) 588-5600

Fax

(951) 588-5603

NPI assigned

Feb 10, 2006

Last updated

Jun 15, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Kwon DDS Professional Corporation

  dba Mead Valley Community Dental Clinic

  • Dentist
  • Perris, CA
  • NPI 1881021434
  Medicare reassignment NPD
• O.J Kwon Dental Corporation

  • Dentist
  • Montclair, CA
  • NPI 1972044337
  Medicare reassignment NPD
• O. Kwon Dental Corporation

  dba Sun Dental

  • General Practice Dentistry
  • Indio, CA
  • NPI 1356029433
  NPD

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1972576866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9939 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033528",
            "telephone_number": "951-588-5600",
            "fax_number": "951-588-5603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9939 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033528",
            "telephone_number": "951-588-5600",
            "fax_number": "951-588-5603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "OH",
        "middle_name": "JAE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "46484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kwangwoo Joseph Whang DMD Inc.
• Andrew Enoch Kwaning
• Alan Kwasman, M.D.
• Cristalle Kwok, OD
• Hannah Cherrin Kwon, PHARMD
• Tony Sang-Jin Kwon, MD
• Vivian Okhee Kwon, D.D.S.
• Yumi Kwon
• Sharon Kwong, BCBA
• Kyceline Trading, LLC

• Dentist in Riverside, CA
• Providers in Riverside, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; 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.

Verify at the official NPI Registry.