Provider Demographics
NPI:1649157975
Name:ALEXIS KWOK DMD INC
Entity type:Organization
Organization Name:ALEXIS KWOK DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WING YAU
Authorized Official - Middle Name:ALEXIS
Authorized Official - Last Name:KWOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-972-0825
Mailing Address - Street 1:4205 VIA MARINA # B302
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-4507
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:903 S BREA BLVD
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5315
Practice Address - Country:US
Practice Address - Phone:714-529-3184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty