KWON DENTISTRY, LLC (NPI# 1851666903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1851666903 |
Entity Type | Organization |
Organization Name | KWON DENTISTRY, LLC |
Other Organization Name | AESTHETIC FAMILY DENTISTRY |
Practice Address |
1201 Se 223rd Ave Suite 120 Gresham OR 97030-2574 |
Practice Telephone | 5036612828 |
Practice Fax Number | 5036189874 |
Mailing Telephone | 5036612828 |
Mailing Fax Number | 5036189874 |
Enumeration Date | 2012-03-21 |
Last Update Date | 2012-03-21 |
Authorized Official Name | DR. ROBIN KWON (DENTIST / OWNER) |
Authorized Official Telephone | 5036612828 |
Authorized Official Credential | DMD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223G0001X |
Dentist Specialization: General Practice |
OR | Dental Providers |
Other Name | Type Code |
---|---|
Aesthetic Family Dentistry | Doing Business As Name - Organization |
Entity Type | Entity Name | Entity Address |
---|---|---|
Oregon Corporations, Companies and Business Names | KWON DENTISTRY, LLC | 1201 Se 223rd Ave Ste 260, Gresham, OR 97030 |
Street Address |
1201 SE 223RD AVE SUITE 120 |
City | GRESHAM |
State | OR |
Zip Code | 97030-2574 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740384460 | Perry A. Stevenson | Dentist | 1201 Se 223rd Ave, Suite 220, Gresham, OR 97030-2574 | 2006-09-12 |
1518302918 | Cascade Vision Center Inc. | Optometrist | 1201 Se 223rd Ave, Suite 160, Gresham, OR 97030-2574 | 2013-04-30 |
1902100316 | Humble Richmond & Russell Oral & Maxillofacial Surgery, LLC | Dentist | 1201 Se 223rd Ave, Suite 180, Gresham, OR 97030-2574 | 2010-12-28 |
1871768853 | Daniel J Ries, Dmd, PC | Clinic/Center | 1201 Se 223rd Ave, Suite 140, Gresham, OR 97030-2574 | 2008-04-29 |
1386784437 | Kevin K Shim | Dentist | 1201 Se 223rd Ave, Suite 260, Gresham, OR 97030-2574 | 2007-02-07 |
1386715910 | Daniel J Ries | Dentist | 1201 Se 223rd Ave, Suite 140, Gresham, OR 97030-2574 | 2006-11-13 |
1366521122 | Douglas Lee Park | Dentist | 1201 Se 223rd Ave, Suite 240, Gresham, OR 97030 | 2006-11-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174032312 | Tiffany Chen | Occupational Therapist | 304 Ne Hood Ave., Gresham, OR 97030 | 2017-09-20 |
1225568454 | Goldstar Vascular Access, Inc | Home Infusion | 2870 Ne Hogan Dr, Ste E #205, Gresham, OR 97030 | 2017-06-20 |
1861940454 | Jessica Morrow | Massage Therapist | 1748 Nw Fairview Dr., Gresham, OR 97030 | 2016-09-13 |
1033665898 | Bonita Baxter | Counselor | 400 Ne 7th Street, Gresham, OR 97030 | 2016-08-31 |
1710335484 | Ethan William Hoccom | Counselor | 1527 Ne Lamesa Place 17th St, Gresham, OR 97030 | 2016-06-02 |
1992159610 | Kathleen Kline, Lmt | Massage Therapist | 1217 Ne Burnside Road Suite 701-d, Gresham, OR 97030 | 2016-04-19 |
1215390109 | The Wallace Medical Concern | Nurse Practitioner | 254 Nw Burnside Road, Gresham, OR 97030 | 2016-03-30 |
1932568912 | Atchison Dialysis, LLC | Clinic/Center | 878 Nw Burnside Rd, Gresham, OR 97030 | 2016-02-18 |
1912374034 | Hilary Dawn Montgomery | Counselor | 1326 Nw Civic Dr # 5569, Gresham, OR 97030 | 2015-08-24 |
1992171730 | Melissa E Childs | Massage Therapist | 1217 Nw Burnside Rd Ste 701, Gresham, OR 97030 | 2015-08-17 |
Find all providers in zip 97030 |
Taxonomy Code | 1223G0001X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | General Practice |
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
Notes: Source: Academy of General Dentistry |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083062020 | Nhu Nguyen | Dentist | 315 Nw Burnside Rd, Gresham, OR 97030-3851 | 2016-06-01 |
1013321587 | Matthew Vogel | Dentist | 1201 Se 223rd Ave Ste 140, Gresham, OR 97030 | 2014-06-12 |
1164680047 | Kurt David Fuerstenau | Dentist | 1605 Sw Walters Dr, Gresham, OR 97080-9355 | 2008-05-28 |
1750587085 | Gary Stewart Cooke | Dentist | 490 E Powell Blvd, Gresham, OR 97030-7610 | 2007-06-24 |
1073730784 | Bradley Fuller | Dentist | 2458 Se Burnside Rd, Gresham, OR 97080-1247 | 2007-04-20 |
1578689659 | Paynter Family Dentistry, PC | Dentist | 445 W Powell Blvd, Gresham, OR 97030-7048 | 2007-03-21 |
1285795690 | Vicki J Reichlein | Dentist | 2039 Ne Burnside Rd, Gresham, OR 97030-7998 | 2006-12-12 |
1982772026 | Cristina Pellicano Kennedy | Dentist | 501 Ne Hood Ave Ste 235, Gresham, OR 97030-7346 | 2006-11-30 |
1720159221 | Raymond Shigeuki Onchi | Dentist | 35 Ne Kelly Ave, Gresham, OR 97030-7539 | 2006-11-13 |
1598854929 | Dmitri Vladislavovich Aleksandrov | Dentist | 600 Ne 8th St Ste 210, Gresham, OR 97030-7341 | 2006-10-12 |
Find all providers in GRESHAM |
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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.