Active NPI
Henry Sang Kwon, D.D.S.
- Endodontics
- Rialto, CA
National Provider Identifier
1982816542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 47505
- Practice address
- 2836 W Rialto Ave # a
Rialto, CA 92376-6743 - Phone
- (909) 820-9454
- Fax
- (909) 820-9482
- NPI assigned
- May 4, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 47505 | CA | Primary |
Addresses
Primary practice location
2836 W Rialto Ave # a
Rialto, CA 92376-6743
Mailing address
1165 Overlook Ridge Rd
Diamond Bar, CA 91765-1133
Phone (213) 675-6418
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 520924 | Other | CA | DENTI-CAL PIN # |
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 |
|---|---|---|---|
| 47505 | CA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778544000000",
"number": "1982816542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1165 OVERLOOK RIDGE RD",
"city": "DIAMOND BAR",
"state": "CA",
"postal_code": "917651133",
"telephone_number": "213-675-6418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2836 W RIALTO AVE # A",
"city": "RIALTO",
"state": "CA",
"postal_code": "923766743",
"telephone_number": "909-820-9454",
"fax_number": "909-820-9482"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWON",
"first_name": "HENRY",
"middle_name": "SANG",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-04",
"last_updated": "2026-05-12",
"certification_date": "2026-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CA",
"license": "47505",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTI-CAL PIN #",
"identifier": "520924",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rialto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.