Provider Demographics
NPI:1295012136
Name:KANG, SONIA SHEMINDERJIT (DDS)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:SHEMINDERJIT
Last Name:KANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6535 ROCHESTER RD
Mailing Address - Street 2:STE 106
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-1362
Mailing Address - Country:US
Mailing Address - Phone:248-879-4548
Mailing Address - Fax:
Practice Address - Street 1:7436 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3100
Practice Address - Country:US
Practice Address - Phone:313-556-9907
Practice Address - Fax:313-556-9711
Is Sole Proprietor?:No
Enumeration Date:2011-11-07
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901019037122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist