Provider Demographics
NPI:1235140427
Name:KANG, BENHUR (DDS)
Entity Type:Individual
Prefix:DR
First Name:BENHUR
Middle Name:
Last Name:KANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5120 HIGHWAY 78
Mailing Address - Street 2:SUITE#400
Mailing Address - City:SACHSE
Mailing Address - State:TX
Mailing Address - Zip Code:75048-4243
Mailing Address - Country:US
Mailing Address - Phone:972-414-2300
Mailing Address - Fax:
Practice Address - Street 1:5120 HIGHWAY 78
Practice Address - Street 2:SUITE#400
Practice Address - City:SACHSE
Practice Address - State:TX
Practice Address - Zip Code:75048-4243
Practice Address - Country:US
Practice Address - Phone:972-414-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20489122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX88D270OtherBCBS PROVIDER #