KENNIE KWOK DMD, INC (NPI# 1073966057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073966057 |
| Entity Type | Organization |
| Organization Name | KENNIE KWOK DMD, INC |
| Other Organization Name | SAN DIEGO PERIODONTICS & IMPLANT DENTISTRY |
| Practice Address |
4060 4th Ave Ste 303 San Diego CA 92103-2120 |
| Practice Telephone | 6195430905 |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-07-14 |
| Authorized Official Name | KENNIE KWOK (PRESIDENT) |
| Authorized Official Telephone | 6195430905 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
65162 | CA | Dental Providers |
| Other Name | Type Code |
|---|---|
| San Diego Periodontics & Implant Dentistry | Doing Business As Name - Organization |
| Street Address |
4060 4TH AVE STE 303 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-2120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457749723 | Nguyen and Yang Dental Partnership | Dentist | 9855 Erma Rd Ste 110, San Diego, CA 92131-1007 | 2015-01-08 |
| 1447653746 | Mac, Maksim and Yang Dental Partnership A General Partnership | Dentist | 9912 Carmel Mountain Rd, San Diego, CA 92129-2808 | 2014-09-30 |
| 1518396621 | Shivali Gohel Garg | Dentist | 4320 Genesee Ave Ste 203, San Diego, CA 92117 | 2013-11-08 |
| 1013215987 | David Chun-te Yu | Dentist | 3141 Trinity Bay Pl, San Diego, CA 92110-5343 | 2011-03-02 |
| 1619295201 | Khanh V. Nguyen, Dds, Inc. | Dentist | 3570 4th Ave, San Diego, CA 92103-4940 | 2010-05-07 |
| 1720302375 | Evelyn Tarcila Huaman | Dentist | 9040 Friars Road Suite #535, San Diego, CA 92108 | 2010-03-24 |
| 1225200371 | Genevieve Abi-nahed | Dentist | 5210 Balboa Ave Ste A2, San Diego, CA 92117 | 2008-03-28 |
| 1396927299 | Khanh Vu Thuy Nguyen | Dentist | 3737 Moraga Ave Ste A104, San Diego, CA 92117 | 2007-12-03 |
| 1740481456 | George Crow | Dentist | 16253 Pinto Ridge Dr, San Diego, CA 92127-3425 | 2007-05-30 |
| 1134345507 | Roya Niakian A Professional Corporation | Dentist | 1111 6th Avenue Ste 102, San Diego, CA 92101 | 2007-04-17 |
| Find all providers in SAN DIEGO | ||||
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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.