JAE H. KWAK (NPI# 1033668355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1033668355 |
Entity Type | Individual |
Full Name | JAE H. KWAK |
Credential | D.M.D. |
Practice Address |
24635 Madison Ave Ste E Murrieta CA 92562-7556 |
Mailing Address |
24635 Madison Ave Murrieta CA 92562-9751 |
Practice Telephone | 9516001062 |
Mailing Telephone | 4694493162 |
Enumeration Date | 2016-09-28 |
Last Update Date | 2018-07-26 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 122300000X | Dentist | 32379 | TX | Dental Providers |
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
102524 | CA | Dental Providers |
Street Address |
24635 MADISON AVE STE E |
City | MURRIETA |
State | CA |
Zip Code | 92562-7556 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386269199 | Lorraine Lau | Dentist | 24635 Madison Ave Ste E, Murrieta, CA 92562-7556 | 2020-06-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831709591 | Brittney Schmidt | Behavior Technician | 25109 Hancock Avenue Suite C, Murrieta, CA 92562 | 2020-08-06 |
1518431410 | Heather Marie Halper | Behavioral Analyst | 25190 Handcock Ave, Suite C, Murrieta, CA 92562 | 2019-01-14 |
1164992798 | Tiffany L Lockhart | Counselor | 41780 Mcalby Ct, Murrieta, CA 92562 | 2018-11-27 |
1164992756 | Jessica Gutierrez | Specialist/Technologist | 25102 Jefferson Ave Suite D, Murrieta, CA 92562 | 2018-11-27 |
1972080455 | Tracy M Bronson | Nurse Practitioner | 23811 Washington Ave Ste C110, #203, Murrieta, CA 92562 | 2018-07-26 |
1023500279 | Brittany Marie Ramirez | Counselor | 23824 Matador Way, Murrieta, CA 92562 | 2018-06-04 |
1053800573 | Emily Kathryn Perrott | Physical Therapist | 24630 Washington Ave Ste 200, Murrieta, CA 92562 | 2018-05-10 |
1285151464 | Dexter Villanueva | Physical Therapist | 40845 Engelmann Oak St., Murrieta, CA 92562 | 2017-08-28 |
1407371024 | Elyaszadeh Levi Dental Corporation | Dentist | 40643 California Oaks Rd, Murrieta, CA 92562 | 2017-08-04 |
1023549037 | Andre Cristian De Jesus | Nurse Practitioner | 24640 Jefferson Ave Ste 208, Murrieta, CA 92562 | 2017-03-22 |
Find all providers in zip 92562 |
Taxonomy Code | 1223P0221X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Pediatric Dentistry |
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124421334 | Shiva Mohazab | Dentist | 24634 Madison Ave Ste E, Murrieta, CA 92562 | 2014-10-01 |
1124119797 | Kim, Kim, Nguyen Dds Dental Corporation | Dentist | 39755 Murrieta Hot Springs Rd Ste E110, Murrieta, CA 92563-9114 | 2006-09-27 |
1386269199 | Lorraine Lau | Dentist | 24635 Madison Ave Ste E, Murrieta, CA 92562-7556 | 2020-06-08 |
1851689871 | Vincent Tu | Dentist | 24635 Madison Ave, Murrieta, CA 92562-9751 | 2011-07-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790385227 | Johnson Ann Wong Dental Corporation | Dentist | 6512 N Figueroa St Ste 3, Los Angeles, CA 90042-2155 | 2020-10-26 |
1205440211 | Jessica Choi, Dmd, Dental Corporation | Dentist | 2318 Huntington Dr, San Marino, CA 91108-2641 | 2020-09-08 |
1659985802 | Rw Fattouch Dmd, Inc. | Dentist | 42210 Lyndie Ln Ste 100, Temecula, CA 92591-3604 | 2020-09-04 |
1174136998 | Armand Begian Dds Inc. | Dentist | 4021 Mission Oaks Blvd # 180, Camarillo, CA 93012-5156 | 2020-08-31 |
1164035473 | Armand Begian Dds Inc. | Dentist | 3687 Las Posas Rd Ste 180, Camarillo, CA 93010-1431 | 2020-08-26 |
1518577972 | Michael Vincent Laureola Dds Inc | Dentist | 2862 Unit A Canyon Springs Parkway, Riverside, CA 92507 | 2020-07-31 |
1396360384 | Drs Salem and Soliman Dental Corp | Dentist | 2119 E Hatch Rd Ste Bandc, Modesto, CA 95351-4814 | 2020-06-15 |
1689299471 | Abhishek Batra | Dentist | 11052 Evans St, Loma Linda, CA 92354-2709 | 2020-06-08 |
1194348060 | Bryan Chao | Dentist | 1895 Mowry Ave Ste 121, Fremont, CA 94538-1736 | 2020-05-26 |
1255953618 | Mohammad Abul-fielat Dds Inc | Dentist | 3825 Tyler St, Riverside, CA 92503 | 2020-05-08 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.