KELLY J HWANG DDS INC (NPI# 1477068930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477068930 |
| Entity Type | Organization |
| Organization Name | KELLY J HWANG DDS INC |
| Practice Address |
11385 Poway Rd Ste 103 San Diego CA 92128-5600 |
| Mailing Address |
757 Poppy Rd San Marcos CA 92078-6905 |
| Practice Telephone | 8584868611 |
| Practice Fax Number | 8584861099 |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2019-06-27 |
| Authorized Official Name | DR. KELLY J HWANG (PRESIDENT) |
| Authorized Official Telephone | 8584868611 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 61930 | CA | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 141 N Main St, Lake Elsinore, CA 925304118 | 9512455003 |
| Street Address |
11385 POWAY RD STE 103 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92128-5600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487042198 | Mina Habibian Dmd Phd Dental Corporation | Clinic/Center | 11385 Poway Rd Ste 103, San Diego, CA 92128-5600 | 2015-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585371 | Alicia Ford | Behavior Technician | 1170 Bernardo Plaza Court, Suite 350, San Diego, CA 92128 | 2020-07-08 |
| 1164087573 | Madeleine White | Dietitian, Registered | 16685 W Bernardo Dr, Suite 121, San Diego, CA 92128 | 2019-05-01 |
| 1053807677 | Joele Ghosn | Speech-Language Pathologist | 11838 Bernardo Plaza Ct #110, San Diego, CA 92128 | 2018-07-06 |
| 1376034348 | Eddie Reginald Burston II | In Home Supportive Care | 12727 Camino Emparrado, San Diego, CA 92128 | 2018-05-24 |
| 1336659218 | Ryan Fong | Physician Assistant | 15004 Innovation Drive (s97), San Diego, CA 92128 | 2017-10-05 |
| 1508316191 | Araceli Flores | Behavioral Analyst | 15737 Innovation Dr, Suite 200, San Diego, CA 92128 | 2016-10-07 |
| 1003283961 | Katherine Dishner | Hearing Instrument Specialist | 16766 Bernardo Center Dr Ste 206, San Diego, CA 92128 | 2015-08-27 |
| 1205212586 | Mobilia Dmd Inc. | Point of Service | 12405 Rancho Bernardo Rd., San Diego, CA 92128 | 2015-08-10 |
| 1346623634 | Angela Christine Storck-petersen | Dietitian, Registered | 11768 Caminito Corriente, San Diego, CA 92128 | 2015-07-04 |
| 1134526874 | Breeana Rose Lancaster | Speech-Language Pathologist | 11838 Bernardo Plaza Ct. Suite 110, Kids Therapy Associates, San Diego, CA 92128 | 2014-11-24 |
| Find all providers in zip 92128 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265048409 | Sara Siraj | Dentist | 7720 Tyrolean Rd, San Diego, CA 92126-1029 | 2020-09-22 |
| 1639785306 | Brittany Jordan Noris | Dentist | 5830 Oberlin Dr Ste 201, San Diego, CA 92121-3754 | 2020-09-18 |
| 1437761475 | Pouya Parsa | Dentist | 12275 Carmel Vista Rd Unit 224, San Diego, CA 92130-2536 | 2020-08-20 |
| 1366060808 | Azadeh Khajavi | Dentist | 16516 Bernardo Center Dr Ste 210, San Diego, CA 92128-2551 | 2020-07-10 |
| 1871127456 | Sandhya Ramanujam | Dentist | 16466 Bernardo Center Dr Ste 185, San Diego, CA 92128-2522 | 2020-02-23 |
| 1396396164 | Khanh Nguyen | Dentist | 8605 Andromeda Rd, San Diego, CA 92126-1803 | 2019-09-24 |
| 1770133977 | Jeffrey Leland Elmer | Dentist | 2310 Craven St Unit 3210, San Diego, CA 92136-5596 | 2019-09-19 |
| 1609429273 | Navya Jampala | Dentist | 10891 Creekbridge Pl, San Diego, CA 92128-5108 | 2019-07-22 |
| 1619529229 | Calli Ann Marando | Dentist | 2310 Craven St # 3230, San Diego, CA 92136-5596 | 2019-07-13 |
| 1669024428 | Bolivia Pereira Hurtado | Dentist | 2303 92136, 2309 Doyle St, San Diego, CA 92136-0001 | 2019-07-11 |
| 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.