# JIAE KWON DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rolling Bay Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770493082
- **Authorized official:** JIAE KWON DDS (MEMBER)
- **Authorized official phone:** (206) 369-7331

## Contact information

- **Practice address:** 730 ERICKSEN AVE NE STE 200, BAINBRIDGE ISLAND, WA 98110-2819
- **Practice address phone:** (206) 842-8686
- **Mailing address:** 730 ERICKSEN AVE NE STE 200, BAINBRIDGE ISLAND, WA 98110-2819
- **Mailing address phone:** (206) 842-8686

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 09/09/2026
- **Last updated:** 09/09/2026
