Provider Demographics
NPI:1508372269
Name:DONG-GIL KANG DDS INC
Entity Type:Organization
Organization Name:DONG-GIL KANG DDS INC
Other - Org Name:OHANA DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONGGIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-912-4270
Mailing Address - Street 1:668 N LOS ROBLES AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1004
Mailing Address - Country:US
Mailing Address - Phone:626-714-7877
Mailing Address - Fax:626-714-7876
Practice Address - Street 1:1414 W COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-1414
Practice Address - Country:US
Practice Address - Phone:626-714-7877
Practice Address - Fax:626-714-7876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-18
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA645661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty