Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tae Kwon

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1992157572

Tae Kwon is a Student in an Organized Health Care Education/Training Program in Fresno, California. Licensed in California. Registered with an NPI since 2016.

Licensed in
CA
In the registry since
2016
Specialties on file
2
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Practice location Address checks out

1161 E Shepherd Ave Apt 201
Fresno, CA 93720-2046
Phone: (310) 890-0816
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthodontics and Dentofacial Orthopedics Dentistry (primary) Taxonomy 1223X0400X · Licence 103782 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1992157572
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 7, 2016
Last updated in NPPESJuly 16, 2019
Mailing address777 Main St Unit 2404, Hartford, CT 06103-2325

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