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KWAK DENTAL MANAGEMENT PLLC NPI 1417129974


NPI Information

NPI: 1417129974
Provider Name: KWAK DENTAL MANAGEMENT, PLLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
638 EAST 169TH STREET
2ND FLOOR
BRONX, NY
ZIP 10456
Phone: (718) 991-8668
Get Directions

KWAK DENTAL MANAGEMENT, PLLC is a general practice dentist in Bronx, NY. The provider is 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. KWAK DENTAL MANAGEMENT, PLLC NPI is 1417129974. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

638 EAST 169TH STREET
2ND FLOOR
BRONX, NY
ZIP 10456
Phone: (718) 991-8668

The provider's authorized official is Hee Joon Kwak .
The authorized official title is Owner and has the following contact phone number (718) 991-8668.

The enumeration date for this NPI number is 3/25/2008 and was last updated on 3/25/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice051024-1NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
102872984MEDICAIDNEW YORK
2180681OTHERNEW YORKDORAL

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.