Healthcare Provider Details

I. General information

NPI: 1417819293
Provider Name (Legal Business Name): BRIAN K KWON, DDS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 SANSOME ST
SAN FRANCISCO CA
94104-3703
US

IV. Provider business mailing address

1881 ROLLINS RD UNIT 3000
BURLINGAME CA
94010-2221
US

V. Phone/Fax

Practice location:
  • Phone: 415-781-1944
  • Fax:
Mailing address:
  • Phone: 818-276-5456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. BRIAN KEEJOON KWON
Title or Position: DENTIST
Credential: DDS
Phone: 818-276-5456