NPI age
9 years
Enumerated 2017-04-07
● Active Type 2 · Organization
Subpart
Samuel S. Kwon,dmd-IV Center Pc
Samuel S. Kwon,dmd-IV Center Pc is 1 of 539 dentist organizations in Georgia.
Primary specialty
Dentist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Salmon
Financial Manager
Last NPPES update
2017-04-11
Source: monthly bulk 2026-05
How this organization compares
Across 539 active dentist providers in Georgia.
NPI age
9 years
↓ 7 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2017 → 2026
2017-04Enumerated in NPPES
2017
2026
Where they practice
Primary practice location
3590 Braselton Hwy Bldg B, Ste 100
Dacula, GA 300191117
Mailing address
3590 Braselton Hwy, Suite 201
Dacula, GA 300191117
Authorized official
Renee Salmon
Financial Manager
📞 6787147575
Specialties
-
Dentist PrimaryAn 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.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 724916844C |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Kwon Pediatric Dentistry
Practice context
Single-site organization. Only one practice location on file.
Subpart of Samuel S. Kwon DMD Pc.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.