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General NPI Number Information
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NPI Number | 1184182040
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Entity Type | Individual
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Provider Name | ISABEL KWON DDS
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Gender | Female
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Dates
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Enumeration Date | 03/08/2019
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Last Update Date | 10/21/2020
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Provider Practice Location Address
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Address Line | 622 W 168TH ST
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City | NEW YORK
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State | NY
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Zip | 10032-3720
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Country | US
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Telephone | 212-305-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 300 3RD ST APT 702
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City | SAN FRANCISCO
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State | CA
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Zip | 94107-1252
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Country | US
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Telephone | 415-967-9698
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 105445
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License Number State | CA
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