TAE KWON (NPI# 1992157572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992157572 |
| Entity Type | Individual |
| Full Name | TAE KWON |
| Practice Address |
1161 E Shepherd Ave Apt 201 Fresno CA 93720-2046 |
| Mailing Address |
777 Main St Unit 2404 Hartford CT 06103-2325 |
| Practice Telephone | 3108900816 |
| Mailing Telephone | 3108900816 |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2019-07-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
103782 | CA | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164821781 | Tae Kwon | Student in an Organized Health Care Education/Training Program | 625 Elmwood Ave, Rochester, NY 14620-2913 | 2014-08-19 |
| 1891982401 | Tae Kwon | Physical Therapist | 611 S Carlin Springs Rd, 505, Arlington, VA 22204-1064 | 2007-09-27 |
| 1073727822 | Tae S Kwon | Psychiatry & Neurology | 110 Wells Farm Rd, Goshen, NY 10924-6740 | 2007-05-10 |
| Street Address |
1161 E SHEPHERD AVE APT 201 |
| City | FRESNO |
| State | CA |
| Zip Code | 93720-2046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366061129 | Ariel Lok Yen Leung | Student in an Organized Health Care Education/Training Program | 1313 East Herndon Ave, St 105, Fresno, CA 93720 | 2020-04-13 |
| 1457992513 | Brittany Nichole Willis | Audiologist | 1351 E Spruce Ave Ste 130, Fresno, CA 93720 | 2019-09-30 |
| 1013567668 | Taylor Courteney Cox | Physical Therapist | 7080 N. Maple Ave #101, Fresno, CA 93720 | 2019-09-16 |
| 1457909152 | Lillian M Augilera | Technician | 8419 N Dearing Ave, Fresno, CA 93720 | 2019-08-27 |
| 1215581764 | Sterling Hospitalist Medical Group, Inc. | Clinic/Center | 1191 E. Herndon Avenue Suite 103, Fresno, CA 93720 | 2019-08-01 |
| 1376006429 | Nancy Minh Thao Dang | Student in an Organized Health Care Education/Training Program | 1313 E. Herndon Ave, St 105, Fresno, CA 93720 | 2019-04-06 |
| 1366904716 | Shankar Nair | Student in an Organized Health Care Education/Training Program | 1313 E. Herndon Ave, St 105., Fresno, CA 93720 | 2019-04-04 |
| 1861979544 | Powell Pediatric Dentistry Chestnut Partnership | Dentist | 7005 N. Chestnut Ave Ste 101, Fresno, CA 93720 | 2018-07-25 |
| 1669967311 | Sierra Pacific Orthopaedic Center Medical Group Inc | Specialist | 1270 E. Spruce, Fresno, CA 93720 | 2018-06-26 |
| 1689168700 | Vinita Vishnoi | Student in an Organized Health Care Education/Training Program | 1313 E. Herndon Ave, St 105, Fresno, CA 93720 | 2018-06-21 |
| Find all providers in zip 93720 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407489610 | Fagin Dental Corporation | Dentist | 7055 N Fresno St Ste 203a, Fresno, CA 93720-2957 | 2020-02-16 |
| 1063942902 | Ryann Christensen | Dentist | 6623 N Riverside Dr Ste 101, Fresno, CA 93722-9325 | 2017-06-14 |
| 1598143208 | Victoria Geren | Dentist | 323 E Bullard Ave Ste 104, Fresno, CA 93710-8620 | 2015-05-13 |
| 1871930545 | Brian Thurman | Dentist | 10221 N Page Ave, Fresno, CA 93730-4507 | 2013-06-04 |
| 1194015594 | Jeffrey Vance Stanley | Dentist | 6465 N Palm Ave Ste 105, Fresno, CA 93704-1085 | 2011-04-19 |
| 1396997979 | Havens Orthodontics, Inc. | Dentist | 7429 N 1st St Ste 101, Fresno, CA 93720-2852 | 2008-10-15 |
| 1194911974 | Charles L Quinlan Dds Inc | Dentist | 7055 N. Fresno Street, #203, Fresno, CA 93720 | 2007-09-14 |
| 1205042116 | Nicole Elise Nalchajian | Dentist | 7501 N Fresno St, Suite 105, Fresno, CA 93720-2458 | 2007-05-15 |
| 1861606147 | William J. Asbury | Dentist | 5479 N Fresno St Ste 102, Fresno, CA 93710-8328 | 2007-05-09 |
| 1205057056 | Pasqualino Diciccio | Dentist | 7104 N. Fresno Street, Suite 102, Fresno, CA 93720 | 2007-05-01 |
| Find all providers in FRESNO | ||||
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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.