SAMUEL S KWON - ATHENS DMD PC (NPI# 1912518531) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912518531 |
| Entity Type | Organization |
| Organization Name | SAMUEL S KWON - ATHENS DMD PC |
| Practice Address |
1795 Resurgence Drive Suite 101 Watkinsville GA 30677 |
| Practice Telephone | 6787147575 |
| Practice Fax Number | 6788049434 |
| Mailing Telephone | 6787147575 |
| Mailing Fax Number | 6788049434 |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2020-08-17 |
| Authorized Official Name | DEANNA MAGUIRE (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 6787147575 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Street Address |
1795 RESURGENCE DRIVE SUITE 101 |
| City | WATKINSVILLE |
| State | GA |
| Zip Code | 30677 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669071478 | Brenda Gerai James | Behavior Technician | 1272 Virgil Langford Rd, Ste 101, Watkinsville, GA 30677 | 2020-10-22 |
| 1881292597 | Chloe Wise | Specialist/Technologist | 360 Caduceus Way Building 600 - Suite 101., Watkinsville, GA 30677 | 2020-10-14 |
| 1972131977 | Hopebridge LLC | Behavioral Analyst | 1272 Virgil Langford Road, Suite 101, Watkinsville, GA 30677 | 2020-03-27 |
| 1306479068 | Meggan Brittany Reed | Counselor | 1550 Jennings Mill Rd, Suite 1700b, Watkinsville, GA 30677 | 2020-02-20 |
| 1699322040 | Christopher's Bridge, LLC | In Home Supportive Care | 3651 Mars Hill Rd, Suite 1600, Watkinsville, GA 30677 | 2019-08-21 |
| 1093209538 | Haley Bauguss | Physician Assistant | 1624 Mars Hill Road, Suite B, Watkinsville, GA 30677 | 2018-06-19 |
| 1134618317 | Amanda Burns Denson | Nurse Practitioner | 1181 Langford Drive, Building 300, Suite 104, Watkinsville, GA 30677 | 2018-05-03 |
| 1780105528 | Inspiring Hospice Partners of Georgia LLC | Hospice Care, Community Based | 1252 Virgil Langford Rd, Watkinsville, GA 30677 | 2017-07-01 |
| 1750753182 | Zachary Russell | Orthopaedic Surgery | 1305 Jennings Mill Road, Building 300, Suite 110, Watkinsville, GA 30677 | 2015-10-26 |
| 1255719720 | Elizabeth Hendrix | Social Worker | 1030 Barber Creek Drive, Suite 313, Watkinsville, GA 30677 | 2015-05-15 |
| Find all providers in zip 30677 | ||||
| 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 |
|---|---|---|---|---|
| 1326194564 | Emily J. Bradley | Dentist | 1091 Park Dr, Ste A, Watkinsville, GA 30677-2014 | 2007-01-27 |
| 1598811739 | Athens Area Pediatric Dentistry, P.C. | Dentist | 1091 Park Dr, Ste A, Watkinsville, GA 30677-2014 | 2007-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740895002 | Ashley Starnesdmd LLC | Dentist | 5482 Chamblee Dunwoody Rd Ste 9, Dunwoody, GA 30338-4142 | 2020-09-14 |
| 1366060618 | A Dental Home 4 Kidz | Dentist | 155 Carnegie Pl Ste 201, Fayetteville, GA 30214-3981 | 2020-07-13 |
| 1255973566 | Rehoboth Life Care Ministries, Inc | Dentist | 3208 Hwy 41, Byron, Byron, GA 31008 | 2019-10-09 |
| 1629619200 | Peachtree Hills Pediatric Dentistry | Dentist | 2385 Peachtree Rd Ne Ste A2ab, Atlanta, GA 30305-4139 | 2019-10-04 |
| 1871145557 | Dogwood Pediatric Dentistry of Statesboro, LLC | Dentist | 123 Hill Pond Ln, Statesboro, GA 30458-0872 | 2019-07-12 |
| 1952969396 | Ns3 Services, LLC | Dentist | 1039 Grant St Se Ste B11, Atlanta, GA 30315-2050 | 2019-05-31 |
| 1871050872 | Warner Robins Pediatric Dentistry LLC | Dentist | 102 S Houston Rd, Warner Robins, GA 31088-3904 | 2019-02-26 |
| 1730646886 | Smiles for Kids Norcross PC | Dentist | 3953 Holcomb Bridge Rd Ste 100, Peachtree Corners, GA 30092-5201 | 2019-02-25 |
| 1073083127 | Pediatric Dentistry of Central Georgia - Macon LLC | Dentist | 5437 Bowman Rd Ste 300, Macon, GA 31210-6575 | 2018-12-03 |
| 1275018582 | Jarrell Pediatric Dentistry, LLC | Dentist | 1538 13th Ave Ste 100, Columbus, GA 31901-1956 | 2018-10-02 |
| Find all providers with the same taxonomy | ||||
| City | WATKINSVILLE |
| Zip Code | 30677 |
Please comment or provide details below to improve the information on SAMUEL S KWON - ATHENS DMD PC.
| 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.