JAE H. KWAK D.M.D. NPI 1033668355

NPI Information

  • NPI: 1033668355
  • Provider Name: JAE H. KWAK, D.M.D.
  • Classification: Dentist - 1223P0221X
  • Specialization: Pediatric Dentistry
  • Entity Type: Individual
  • Address: 1631 EDINGER AVE STE 105
    TUSTIN, CA
    ZIP 92780
  • Phone: (714) 717-3757

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NPI Details

Jae H. Kwak, D.M.D. is a pediatric dentistry dentist in Tustin, CA. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. Jae H. Kwak, D.M.D. NPI is 1033668355. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1631 EDINGER AVE STE 105
TUSTIN, CA
ZIP 92780-537
Phone: (714) 717-3757

The enumeration date for this NPI number is 9/28/2016 and was last updated on 3/2/2023.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1122300000XDentist32379TEXASNo
21223P0221XDentistPediatric Dentistry102524CALIFORNIAYes

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: 3/30/2025

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